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An Immunological Basis for Chronic Histiocytic Intervillositis in Recurrent Fetal Loss
Author(s) -
Reus Averil D.,
Besouw Nicole M.,
Molenaar Nikki M.,
Steegers Eric A.P.,
Visser Willy,
Kuiper Ronella P.,
Krijger Ronald R.,
Roelen Dave L.,
Exalto Niek
Publication year - 2013
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12125
Subject(s) - pregnancy , medicine , immunology , cytotoxic t cell , histiocyte , immune system , antibody , fetus , human leukocyte antigen , lymphocyte , cellular immunity , antigen , biology , biochemistry , genetics , in vitro
Problem Chronic histiocytic intervillositis ( CHIV ) is a rare type of placental pathology that is associated with reproductive loss at all gestational ages. The aim of the study was to investigate the relationship between the severity of CHIV and the outcome of pregnancy and to compare the immune response between CHIV patients and controls to explore an immunological origin of CHIV . Method of study Microscopic slides were reviewed and scored according to a previously published grading system in 30 pregnancies of 22 CHIV patients. Partner‐specific mixed lymphocyte reactions, cytotoxic T‐lymphocyte precursor frequencies ( CTL pf), and anti‐ HLA antibodies were determined in four patients and seven controls. Results Higher CHIV scores are associated with worse pregnancy outcome. CHIV patients demonstrated a higher CTL pf against their partner compared to non‐complicated pregnancies ( P = 0.03). The CTL pf was extremely high in 75% of the patients. Antipaternal HLA antibodies were only present in 75% of the CHIV patients compared to none of the controls ( P = 0.02). Conclusion CHIV scores seem to be associated with the severity of adverse pregnancy outcome. High antipaternal cellular (T‐cell) and humoral (B‐cell) response to partner‐specific CTL pf and the presence of anti‐ HLA antibodies directed to the partner suggest an immunologic origin of CHIV .