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      Tissue-Specific Education of Decidual NK Cells

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          Abstract

          During human pregnancy, fetal trophoblast cells invade the decidua and remodel maternal spiral arteries to establish adequate nutrition during gestation. Tissue NK cells in the decidua (dNK) express inhibitory NK receptors (iNKR) that recognize allogeneic HLA-C molecules on trophoblast. Where this results in excessive dNK inhibition, the risk of pre-eclampsia or growth restriction is increased. However, the role of maternal, self–HLA-C in regulating dNK responsiveness is unknown. We investigated how the expression and function of five iNKR in dNK is influenced by maternal HLA-C. In dNK isolated from women who have HLA-C alleles that carry a C2 epitope, there is decreased expression frequency of the cognate receptor, KIR2DL1. In contrast, women with HLA-C alleles bearing a C1 epitope have increased frequency of the corresponding receptor, KIR2DL3. Maternal HLA-C had no significant effect on KIR2DL1 or KIR2DL3 in peripheral blood NK cells (pbNK). This resulted in a very different KIR repertoire for dNK capable of binding C1 or C2 epitopes compared with pbNK. We also show that, although maternal KIR2DL1 binding to C2 epitope educates dNK cells to acquire functional competence, the effects of other iNKR on dNK responsiveness are quite different from those in pbNK. This provides a basis for understanding how dNK responses to allogeneic trophoblast affect the outcome of pregnancy. Our findings suggest that the mechanisms that determine the repertoire of iNKR and the effect of self-MHC on NK education may differ in tissue NK cells compared with pbNK.

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          NK cell recognition.

          The integrated processing of signals transduced by activating and inhibitory cell surface receptors regulates NK cell effector functions. Here, I review the structure, function, and ligand specificity of the receptors responsible for NK cell recognition.
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            Rheological and Physiological Consequences of Conversion of the Maternal Spiral Arteries for Uteroplacental Blood Flow during Human Pregnancy

            Physiological conversion of the maternal spiral arteries is key to a successful human pregnancy. It involves loss of smooth muscle and the elastic lamina from the vessel wall as far as the inner third of the myometrium, and is associated with a 5–10-fold dilation at the vessel mouth. Failure of conversion accompanies common complications of pregnancy, such as early-onset preeclampsia and fetal growth restriction. Here, we model the effects of terminal dilation on inflow of blood into the placental intervillous space at term, using dimensions in the literature derived from three-dimensional reconstructions. We observe that dilation slows the rate of flow from 2 to 3 m/s in the non-dilated part of an artery of 0.4–0.5 mm diameter to approximately 10 cm/s at the 2.5 mm diameter mouth, depending on the exact radius and viscosity. This rate predicts a transit time through the intervillous space of approximately 25 s, which matches observed times closely. The model shows that in the absence of conversion blood will enter the intervillous space as a turbulent jet at rates of 1–2 m/s. We speculate that the high momentum will damage villous architecture, rupturing anchoring villi and creating echogenic cystic lesions as evidenced by ultrasound. The retention of smooth muscle will also increase the risk of spontaneous vasoconstriction and ischaemia–reperfusion injury, generating oxidative stress. Dilation has a surprisingly modest impact on total blood flow, and so we suggest the placental pathology associated with deficient conversion is dominated by rheological consequences rather than chronic hypoxia.
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              Combinations of Maternal KIR and Fetal HLA-C Genes Influence the Risk of Preeclampsia and Reproductive Success

              Preeclampsia is a serious complication of pregnancy in which the fetus receives an inadequate supply of blood due to failure of trophoblast invasion. There is evidence that the condition has an immunological basis. The only known polymorphic histocompatibility antigens on the fetal trophoblast are HLA-C molecules. We tested the idea that recognition of these molecules by killer immunoglobulin receptors (KIRs) on maternal decidual NK cells is a key factor in the development of preeclampsia. Striking differences were observed when these polymorphic ligand: receptor pairs were considered in combination. Mothers lacking most or all activating KIR (AA genotype) when the fetus possessed HLA-C belonging to the HLA-C2 group were at a greatly increased risk of preeclampsia. This was true even if the mother herself also had HLA-C2, indicating that neither nonself nor missing-self discrimination was operative. Thus, this interaction between maternal KIR and trophoblast appears not to have an immune function, but instead plays a physiological role related to placental development. Different human populations have a reciprocal relationship between AA frequency and HLA-C2 frequency, suggesting selection against this combination. In light of our findings, reproductive success may have been a factor in the evolution and maintenance of human HLA-C and KIR polymorphisms.
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                Author and article information

                Journal
                J Immunol
                J. Immunol
                jimmunol
                jimmunol
                JI
                The Journal of Immunology Author Choice
                AAI
                0022-1767
                1550-6606
                1 October 2015
                28 August 2015
                : 195
                : 7
                : 3026-3032
                Affiliations
                [* ]Department of Pathology, University of Cambridge, Cambridge CB2 1QP, United Kingdom;
                []Centre for Trophoblast Research, University of Cambridge, Cambridge CB2 1QP, United Kingdom; and
                []Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge CB2 0SW, United Kingdom
                Author notes
                [1]

                A.M.S. and S.X. contributed equally to this work.

                A.M. and F.C. conceived the idea for this project, coordinated the work, and oversaw writing of the manuscript; A.M.S. and S.X. designed the experiments, performed NK cell isolations and phenotyping, functional experiments, and data analysis and interpretation, and jointly wrote the manuscript; additional decidual leukocyte and PBMC samples were isolated and analyzed by P.R.K., M.A.I., and O.C.; and KIR and HLA-C genotyping of donor DNA samples was carried out by S.E.H., L.E.F., L.G., and O.C.

                Address correspondence and reprint requests to Dr. Andrew M. Sharkey, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, U.K. E-mail address: as168@ 123456cam.ac.uk
                Author information
                http://orcid.org/0000-0002-5072-7748
                Article
                ji_1501229
                10.4049/jimmunol.1501229
                4574523
                26320253
                a8da62b1-e17a-4711-bd52-b4f1b219bcd1
                Copyright © 2015 The Authors

                This is an open-access article distributed under the terms of the CC-BY 3.0 Unported license .

                History
                : 28 May 2015
                : 28 July 2015
                Page count
                Pages: 7
                Categories
                Clinical and Human Immunology

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