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      Placental Expression of CD100, CD72 and CD45 Is Dysregulated in Human Miscarriage

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          Abstract

          Context and Objective

          The etiology of miscarriage is often multifactorial. One major cause, immunological rejection of the fetus, has not been clearly elucidated. Our aim was to establish whether the semaphorin CD100, its natural receptor CD72, and the glycoprotein CD45, implicated in immune mechanisms, are involved in pregnancy loss by examining their placental expression with real-time PCR, immunohistochemistry and western blotting techniques.

          Patients

          Placenta tissue from 72 Caucasian women undergoing surgical uterine evacuation due to early spontaneous pregnancy loss between the 8 th and 12 th week of gestation was divided into four groups based on miscarriage number. Gestational age-matched placentas from 18 healthy women without a history of miscarriage undergoing voluntary pregnancy termination were the control group. Placenta from 6 Caesarean deliveries performed at 38–40 weeks of gestation was also studied.

          Results

          CD100, CD72 and CD45 were expressed in placenta and exhibited different mRNA and protein levels in normal pregnancy and miscarriage. In particular, protein levels were highly dysregulated around 10 weeks of gestation in first and second miscarriage placentas. The CD100 soluble form was produced and immediately shed from placental tissue in all samples.

          Conclusions

          Fetal CD100, CD72 and CD45 seem to play a role in miscarriage. The present data support the involvement of the fetal immune system in pregnancy maintenance as well as failure.

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          Most cited references38

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          Maternal alloantigens promote the development of tolerogenic fetal regulatory T cells in utero.

          As the immune system develops, T cells are selected or regulated to become tolerant of self antigens and reactive against foreign antigens. In mice, the induction of such tolerance is thought to be attributable to the deletion of self-reactive cells. Here, we show that the human fetal immune system takes advantage of an additional mechanism: the generation of regulatory T cells (Tregs) that suppress fetal immune responses. We find that substantial numbers of maternal cells cross the placenta to reside in fetal lymph nodes, inducing the development of CD4+CD25highFoxP3+ Tregs that suppress fetal antimaternal immunity and persist at least until early adulthood. These findings reveal a form of antigen-specific tolerance in humans, induced in utero and probably active in regulating immune responses after birth.
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            T cell awareness of paternal alloantigens during pregnancy.

            During pregnancy a semiallogeneic fetus survives despite the presence of maternal T cells specific for paternally inherited histocompatibility antigens. A mouse transgenic for a T cell receptor recognizing the major histocompatibility (MHC) antigen H-2Kb was used to follow the fate of T cells reactive to paternal alloantigens. In contrast to syngeneic and third-party allogeneic pregnancies, mice bearing a Kb-positive conceptus had reduced numbers of Kb-reactive T cells and accepted Kb-positive tumor grafts. T cell phenotype and responsiveness were restored after delivery. Thus, during pregnancy maternal T cells acquire a transient state of tolerance specific for paternal alloantigens.
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              Paternal age and maternal age are risk factors for miscarriage; results of a multicentre European study.

              It is well known that miscarriage risk increases with age. However, studies usually investigate only maternal age effects. We investigated both maternal age and paternal age effects on miscarriage risk to provide insight into this frequent reproductive failure. The last planned pregnancies (n = 3174) that ended in a birth or miscarriage were analysed in a retrospective population-based study on women aged 25-44 years in Denmark, Germany, Italy and Spain. Maternal and paternal ages were analysed together, using a single variable 'couple age' in a multivariate logistic regression analysis, with couples composed of a woman and a man both aged 20-29 years forming the reference group. After adjustment for various factors (e.g. reproductive history, country), we found that the risk of miscarriage was higher if the woman was aged > or = 35 years, as has already been reported in a number of studies. However, the increase in risk was much greater for couples composed of a woman aged > or = 35 years and of a man aged > or = 40 years. Potential source of bias (especially 'reproductive compensation') are discussed. The risk of an adverse pregnancy outcome is highest if both partners are advanced in age.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2012
                11 May 2012
                : 7
                : 5
                : e35232
                Affiliations
                [1 ]Division of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, School of Medicine, Università Politecnica delle Marche, Ancona, Italy
                [2 ]Unit of Obstetrics and Gynecology at "G. Salesi" Hospital, Department of Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
                [3 ]Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Ancona, Italy
                [4 ]Unit of Obstetrics and Gynecology, San Severino Marche Hospital, San Severino Marche, Italy
                Brigham and Women’s Hospital, United States of America
                Author notes

                Conceived and designed the experiments: TL AT ML MC DM. Performed the experiments: TL ML FP FM LL DM. Analyzed the data: TL ML FP FM LL DM PC. Contributed reagents/materials/analysis tools: AT MM MC DM. Wrote the paper: TL DM. Collection of samples: AM ALT. Final approval of the version to be published: MM AM ALT MC.

                Article
                PONE-D-11-09594
                10.1371/journal.pone.0035232
                3350501
                22606231
                825ee0f9-8461-4ca7-b12e-68b17301b6b7
                Lorenzi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 26 May 2011
                : 13 March 2012
                Page count
                Pages: 15
                Categories
                Research Article
                Biology
                Anatomy and Physiology
                Immune Physiology
                Immune Cells
                Biochemistry
                Genetics
                Molecular Genetics
                Gene Regulation
                Gene Expression
                Immunology
                Immune Response
                Medicine
                Obstetrics and Gynecology
                Pregnancy
                Miscarriage and Stillbirth

                Uncategorized
                Uncategorized

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