Abstract
Decidual macrophages (DM) are the second most abundant population in the fetal-maternal interface. Their role has been so far identified as being local immuno-modulators favoring the maternal tolerance to the fetus. Herein we investigated tissue samples from 11 cases of spontaneous miscarriages and from 9 cases of elective terminations of pregnancy. Using immunohistochemistry and dual immunofluorescence we have demonstrated that in spontaneous miscarriages the DM are significantly increased. Additionally, we noted a significant up-regulation of macrophage FasL expression. Our results further support a dual role for DM during pregnancy and miscarriages. We hypothesize that the baseline DM population in normal pregnancy is in line with an M2 phenotype supporting the ongoing gestation. In contrast, during spontaneous miscarriages, the increased FasL-expressing population could be a part of an M1 phenotype participating in Fas/FasL-related apoptosis. Our results highlight a new aspect of macrophage biology in pregnancy physiology and pathophysiology. Further studies with larger samples are needed to verify the current results and evaluate their clinical impact.
Highlights
The effectiveness of human reproduction is rather limited
Decidual macrophages (DM) are the second more abundant population identified in the fetal maternal interface [6]
It has been shown that DM but not peripheral monocytes can inhibit T-cell responses most possibly via prostaglandin E2 production [12,13]
Summary
The effectiveness of human reproduction is rather limited. About 70% of the spontaneous conceptions will be lost during the first trimester. Most of them (85%) are lost in a pre-clinical phase, prior to any clinical verification of pregnancy; the rest are expected to be lost at a later clinical stage during the first trimester [1]. Several causes have been attributed to miscarriages. Chromosomal abnormalities, not often verified, are considered a common cause. Other reported causes are intra-uterine infections, endocrinological/immunological disorders, anatomical problems of the uterus and pharmaceutical/chemical effects on embryo implantation and development [2]
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