Immunopathological insights into villitis of unknown etiology on the basis of transplant immunology

Damas, Ingrid Iara; Lavareze, Luccas; Scarini, João Figueira; Lima‐Souza, Reydson Alcides de; Emerick, Carolina; Gonçalves, Mayara Trevizol; Figueiredo-Maciel, Tayná; Vieira, Gustavo de Souza; Kimura, Talita de Carvalho; Aquino, Iara Gonçalves; Paiva, João Paulo Gonçalves de; Helms, My N.; Mariano, Fernanda Viviane; Altemani, Albina; Egal, Érika Said Abu

doi:10.1016/j.placenta.2022.11.003

Cited by 1 publication

(1 citation statement)

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“…In VUE, lymphocytes of maternal origin have been proved by human leukocyte antigen (HLA) mismatch and are considered a type of autoimmune response against the fetus [22][23][24][25]. Maternal T cells are chemotactically attracted into the villous stroma by activated fetal Hofbauer cells, being a unique allograft rejection [26,27]. Villous injury may be mediated by the perforin/granzyme pathway and C5b-9, which could lead to villous apoptosis [28].…”

Section: Discussionmentioning

confidence: 99%

Discordant Eosinophilic/T-Cell Chorionic Vasculitis in a Dichorionic Diamniotic Placenta

Silvestri

Servadei

Tamagnini

et al. 2023

IJMS

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Eosinophilic/T-cell chorionic vasculitis (ETCV) is an idiopathic lesion composed of eosinophils, CD3+ T lymphocytes, and histiocytes. In twins, ETCV may affect only one chorionic plate, a feature defined as “discordant”. We present a case of ETCV discordance in a diamniotic dichorionic placenta at 38 weeks of gestation, in which the female twin was small for gestational age, weighing 2670 g (25th percentile). The corresponding placental territory presented ETCV in two close chorionic vessels with concordance of the fetal inflammatory response. Immunohistochemistry showed an abundance of CD3+/CD4+/CD25+T lymphocytes, CD68 PG M1+ macrophages, and scattered CD8+ T cells with focal TIA-1 positivity. Granzyme B, CD20 B lymphocytes, and CD56 natural killer cells were negative. High-grade villitis of unknown etiology (VUE) was additionally found and displayed comparable ETCV findings, except for an equivalent ratio of CD4+/CD8+ T cells, but TIA-1 was focally expressed. VUE was associated with chronic histiocytic intervillositis (CHI). The combination of ETCV, VUE, and CHI may have been responsible for reduced fetal growth. Concordance was observed in the ETCV and TIA-1 expression, both in ETCV and in VUE, which is a maternal response. These findings may suggest a common antigen or chemokine pathway to which both mother and fetus accordingly responded.

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