Beyond Uterine Natural Killer Cell Numbers in Unexplained Recurrent Pregnancy Loss: Combined Analysis of CD45, CD56, CD16, CD57, and CD138

oleh: Maia Chiokadze, Christin Bär, Jana Pastuschek, Boris V. Dons’koi, Kseniia G. Khazhylenko, Ekkehard Schleußner, Udo R. Markert, Rodolfo R. Favaro

Format: Article
Diterbitkan: MDPI AG 2020-08-01

Deskripsi

Changes in the number and cytotoxic potential of uterine Natural Killer (uNK) cells have been associated with reduced fertility. To provide a better characterization of immunophenotypes in the endometrium of women with uRPL (unexplained recurrent pregnancy loss), we examined the applicability of a set of five immune cell markers. The concentration (cells/mm<sup>2</sup>) of CD45<sup>+</sup> leukocytes, CD56<sup>+</sup> uNK cells, and CD138<sup>+</sup> plasma cells as well as of CD16<sup>+</sup> and CD57<sup>+</sup> cells, which indicate high cytotoxic uNK cells, were assessed by immunohistochemistry in endometrial biopsies from 61 uRPL patients and 10 controls. Control fertile endometria presented 90–300 CD56<sup>+</sup> uNK cells/mm<sup>2</sup>. uRPL cases were classified in subgroups of low (uRPL-CD56<sup>low</sup> < 90 cells/mm<sup>2</sup>), normal (uRPL-CD56<sup>normal</sup> 90–300 cells/mm<sup>2</sup>), and high uNK cell counts (uRPL-CD56<sup>high</sup> > 300 cells/mm<sup>2</sup>). Some cases from the uRPL-CD56<sup>low</sup> and uRPL-CD56<sup>normal</sup> subgroups showed elevated proportions of cytotoxic CD16<sup>+</sup> and CD57<sup>+</sup> cells in relation to CD56<sup>+</sup> cells. In the uRPL-CD56<sup>high</sup> subgroup, the CD57/CD56 ratio was reduced in most samples and the CD16/CD56 ratio was unaltered. Analysis of CD138 excluded the influence of chronic endometritis on these observations. Our results reinforce a link between uRPL and a dysfunctional endometrial environment associated with distinct immune cell profiles.