Pre-eclampsia is associated with dendritic cell recruitment into the uterine decidua

• Published in: The Journal of pathology Vol. 214; no. 3; pp. 328 - 336
• Main Authors: Huang, SJ, Chen, C.P, Schatz, F, Rahman, M, Abrahams, VM, Lockwood, CJ
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.02.2008; Wiley
• Subjects: Biological and medical sciences; Case-Control Studies; Cell Movement - drug effects; Cells, Cultured; chemokines; Chemokines - genetics; Chemokines - metabolism; Culture Media, Conditioned - pharmacology; Decidua - immunology; Decidua - pathology; dendritic cells; Dendritic Cells - drug effects; Dendritic Cells - pathology; Diseases of mother, fetus and pregnancy; Enzyme-Linked Immunosorbent Assay - methods; Female; Gene Expression Profiling; Gynecology. Andrology. Obstetrics; Humans; Immunohistochemistry; inflammation; Interleukin-1beta - pharmacology; Investigative techniques, diagnostic techniques (general aspects); macrophages; Medical sciences; Oligonucleotide Array Sequence Analysis; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; pre-eclampsia; Pre-Eclampsia - immunology; Pre-Eclampsia - pathology; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Third; Pregnancy. Fetus. Placenta; Reverse Transcriptase Polymerase Chain Reaction; trophoblast invasion; Up-Regulation; Trophoblaste; Dendritic cell; Pregnancy disorders; Fetal membrane; Tumorous infiltration; Inflammation; pre-eclampsia; Decidua; chemokines; Pregnancy toxemia; Invasion; Recruitment; Chemokine; Pregnancy; Anatomic pathology; macrophages; Association; dendritic cells; Uterus; Antigen presenting cell; Preeclampsia; Female genital system; Macrophage; trophoblast invasion
• ISSN: 0022-3417; 1096-9896
• DOI: 10.1002/path.2257

Pre-eclampsia is a leading cause of fetal and maternal morbidity and mortality that preferentially affects primiparous patients. It is associated with systemic inflammation and impaired trophoblast invasion of the decidua. Decidual cells are the major cell type of the pregnant endometrium. Macrophages and dendritic cells are major specialized antigen-presenting cells that promote both innate immunity and immune tolerance. Macrophage infiltration is implicated in impaired trophoblast invasion that leads to pre-eclampsia. By contrast, the potential modulating role of decidual dendritic cells in the genesis of pre-eclampsia has not been investigated. Interleukin-1beta (IL-1β), a pro-inflammatory cytokine, has been implicated in the genesis of pre-eclampsia. Thus, we postulate that pre-eclampsia would be associated with enhanced decidual dendritic cells infiltration and that IL-1β would enhance the production of relevant dendritic cell-recruiting chemokines. We used immunohistochemistry to demonstrate a marked infiltrate of immature and mature dendritic cells in pre-eclamptic decidua. Further, immunohistochemistry and immunoassays of placental bed biopsies revealed that pre-eclamptic decidua displays elevated levels of several monocyte- and dendritic cell-recruiting chemokines. Leukocyte-free first-trimester decidual cells were then treated with IL-1β, which enhanced the mRNA and protein expression of these chemokines. The current study also confirmed previous reports that macrophages directly impaired trophoblast invasion and that this inhibitory effect is augmented by the conditioned medium of IL-1β-treated first-trimester decidual cells. However, unlike macrophages, dendritic cells did not directly impede trophoblast invasion. This study demonstrates that the inflammatory milieu of pre-eclampsia induces decidual cells to promote dendritic cell infiltration. Given their unusual versatility in mediating both immunity and tolerance, these novel findings suggest that dendritic cells may play a critical role either in the pathogenesis of pre-eclampsia or its prevention in subsequent pregnancies. Copyright © 2007 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.