CD25+FOXP3+ and CD4+CD25+ cells distribution in decidual departments of women with severe and mild pre-eclampsia: Comparison with healthy pregnancies
Corresponding Author
Martina Orlovic Vlaho
Department of Obstetrics, Gynecology University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Correspondence
Orlovic Vlaho Martina, Department of Obstetrics, Gynecology University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.
Email: [email protected]
Search for more papers by this authorVajdana Tomic
Department of Obstetrics, Gynecology University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Faculty of Health Studies, University of Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorKatarina Vukojevic
Laboratory of Morphology, Department of Histology and Embryology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
Laboratory for Early Human Development, Department of Anatomy, Histology and Embryology, School of Medicine, University of Split, Split, Croatia
Search for more papers by this authorAnja Vasilj
Department of Obstetrics, Gynecology University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorRenato Pejic
University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorJosip Lesko
University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorVioleta Soljic
Laboratory of Morphology, Department of Histology and Embryology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorCorresponding Author
Martina Orlovic Vlaho
Department of Obstetrics, Gynecology University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Correspondence
Orlovic Vlaho Martina, Department of Obstetrics, Gynecology University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.
Email: [email protected]
Search for more papers by this authorVajdana Tomic
Department of Obstetrics, Gynecology University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Faculty of Health Studies, University of Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorKatarina Vukojevic
Laboratory of Morphology, Department of Histology and Embryology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
Laboratory for Early Human Development, Department of Anatomy, Histology and Embryology, School of Medicine, University of Split, Split, Croatia
Search for more papers by this authorAnja Vasilj
Department of Obstetrics, Gynecology University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorRenato Pejic
University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorJosip Lesko
University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorVioleta Soljic
Laboratory of Morphology, Department of Histology and Embryology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
Search for more papers by this authorAbstract
Problem
The aim of this study was to quantify and compare the distribution of regulatory CD25+FOXP3+ and activated CD4+CD25+ T cells in decidua basalis and parietalis of severe and mild pre-eclampsia (PE) to normal healthy pregnancies.
Method of study
Decidual tissue (decidua basalis and parietalis) of 13 women with mild PE, 15 women with severe PE, and 19 women with healthy term pregnancies were analyzed by immunohistochemistry and double immunofluorescence.
Results
The total number of CD25+FOXP3+ cells/mm2 in decidua basalis was decreased in the severe and mild PE versus normal pregnancy group. The total number of CD4+CD25+ cells/mm2 in decidua basalis was decreased in the severe PE versus normal pregnancy group. The number of CD25+FOXP3+ and CD4+CD25+ cells in decidua parietalis was decreased in both PE groups.
Conclusion
Our data suggest that immunological changes of PE reflect on decidua basalis and parietalis and emphasize the importance of characterizing T cells in both decidual departments.
CONFLICT OF INTEREST
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.
REFERENCES
- 1Nancy P, Erlebacher A. T cell behavior at the maternal-fetal interface. Int J Dev Biol. 2014; 58: 189-198.
- 2Steinborn A, Schmitt E, Kisielewicz A, et al. Pregnancy-associated diseases are characterized by the composition of the systemic regulatory T cell (Treg) pool with distinct subsets of Tregs. Clin Exp Immunol. 2012; 167: 84-98.
- 3Hosseini A, Dolati S, Hashemi V, Abdollahpour-Alitappeh M, Yousefi M. Regulatory T and T helper 17 cells: Their roles in preeclampsia. J Cell Physiol. 2018; 233: 6561-6573.
- 4Leber A, Teles A, Zenclussen AC. Regulatory T cells and their role in pregnancy. Am J Reprod Immunol. 2010; 63: 445-459.
- 5Toldi G, Vásárhelyi ZE, Rigó J, et al. Prevalence of regulatory T-Cell subtypes in preeclampsia. Am J Reprod Immunol. 2015; 74: 110-115.
- 6Inada K, Shima T, Ito M, Ushijima A, Saito S. Helios-positive functional regulatory T cells are decreased in decidua of miscarriage cases with normal fetal chromosomal content. J Reprod Immunol. 2015; 107: 10-19.
- 7Saito S, Shiozaki A, Sasaki Y, Nakashima A, Shima T, Ito M. Regulatory T cells and regulatory natural killer (NK) cells play important roles in feto-maternal tolerance. Semin Immunopathol. 2007; 29: 115-122.
- 8Sasaki Y, Sakai M, Miyazaki S, Higuma S, Shiozaki A, Saito S. Decidual and peripheral blood CD4+CD25+ regulatory T cells in early pregnancy subjects and spontaneous abortion cases. Mol Hum Reprod. 2004; 10: 347-353.
- 9Quinn KH, Lacoursiere DY, Cui L, Bui J, Parast MM. The unique pathophysiology of early-onset severe preeclampsia: role of decidual T regulatory cells. J Reprod Immunol. 2011; 91: 76-82.
- 10Sasaki Y, Darmochwal-Kolarz D, Suzuki D, et al. Proportion of peripheral blood and decidual CD4(+) CD25(bright) regulatory T cells in pre-eclampsia. Clin Exp Immunol. 2007; 149: 139-145.
- 11Rieger L, Segerer S, Bernar T, et al. Specific subsets of immune cells in human decidua differ between normal pregnancy and preeclampsia–a prospective observational study. Reprod Biol Endoc. 2009; 7: 132.
- 12Steinborn A, Haensch GM, Mahnke K, et al. Distinct subsets of regulatory T cells during pregnancy: is the imbalance of these subsets involved in the pathogenesis of preeclampsia? Clin Immunol. 2008; 129(3): 401-412.
- 13Prins JR, Boelens HM, Heimweg J, et al. Preeclampsia is associated with lower percentages of regulatory T cells in maternal blood. Hypertens Pregnancy. 2009; 28(3): 300-311.
- 14Darmochwal-Kolarz D, Saito S, Tabarkiewicz J, et al. Apoptosis signaling is altered in CD4(+)CD25(+)FoxP3(+) T regulatory lymphocytes in pre-eclampsia. Int J Mol Sci. 2012; 13: 6548-6560.
- 15Paeschke S, Chen F, Horn N, et al. Pre-eclampsia is not associated with changes in the levels of regulatory T cells in peripheral blood. Am J Reprod Immunol. 2005; 54: 384-389.
- 16Hu D, Chen Y, Zhang W, Wang H, Wang Z, Dong M. Alteration of peripheral CD4+CD25+ regulatory T lymphocytes in pregnancy and pre-eclampsia. Acta Obstet Gynecol Scand. 2008; 87: 190-194.
- 17Ferreira LM, Meissner TB, Tilburgs T, Strominger JL. HLA-G: at the interface of maternal-fetal tolerance. Trends Immunol. 2017; 38: 272-286.
- 18Lissauer D, Kilby MD, Moss P. Maternal effector T cells within decidua: The adaptive immune response to pregnancy? Placenta. 2017; 60: 140-144.
- 19Powell RM, Lissauer D, Tamblyn J, et al. Decidual T cells exhibit a highly differentiated phenotype and demonstrate potential fetal specificity and a strong transcriptional response to IFN. J Immunol. 2017; 199: 3406-3417.
- 20Dimova T, Nagaeva O, Stenqvist AC, et al. Maternal Foxp3 expressing CD4+ CD25+ and CD4+ CD25- regulatory T-cell populations are enriched in human early normal pregnancy decidua: a phenotypic study of paired decidual and peripheral blood samples. Am J Reprod Immunol. 2011; 66: 44-56.
- 21Mjosberg J, Berg G, Jenmalm MC, Ernerudh J. FOXP3+ regulatory T cells and T helper 1, T helper 2, and T helper 17 cells in human early pregnancy decidua. Biol Reprod. 2010; 82: 698-705.
- 22Tilburgs T, Roelen DL, van der Mast BJ, et al. Evidence for a selective migration of fetus-specific CD4+CD25bright regulatory T cells from the peripheral blood to the decidua in human pregnancy. J Immunology. 2008; 180: 5737-5745.
- 23Sindram-Trujillo A, Scherjon S, Kanhai H, Roelen D, Claas F. Increased T-cell activation in decidua parietalis compared to decidua basalis in uncomplicated human term pregnancy. Am J Reprod Immunol. 2003; 49: 261-268.
- 24Tilburgs T, Roelen D, Vandermast B, et al. Differential distribution of CD4(+)CD25(bright) and CD8(+)CD28(-) T-cells in decidua and maternal blood during human pregnancy. Placenta. 2006; 27: S47-53.
- 25Solders M, Gorchs L, Gidlof S, Tiblad E, Lundell AC, Kaipe H. Maternal adaptive immune cells in decidua parietalis display a more activated and coinhibitory phenotype compared to decidua basalis. Stem Cells Int. 2017; 2017: 8010961.
- 26Liu X, Wang X, Ding J, et al. FOXP3 and CD25 double staining antibody cocktails identify regulatory T cells in different types of tumor tissues using tissue microarrays. Ann Diagn Pathol. 2019; 38: 67-70.
- 27Saito S, Sasaki Y, Sakai M. CD4(+)CD25high regulatory T cells in human pregnancy. J Reprod Immunol. 2005; 65: 111-120.
- 28Salvany-Celades M, van der Zwan A, Benner M, et al. Three types of functional regulatory T cells control T cell responses at the human maternal-fetal interface. Cell Rep. 2019; 27(2537–2547):e2535.
- 29 American College of Obstetricians and Gynecologists TFoHiP. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' task force on hypertension in pregnancy. Obstet Gynecol. 2013; 122(1122).
- 30Burton GJ, Sebire NJ, Myatt L, et al. Optimising sample collection for placental research. Placenta. 2014; 35: 9-22.
- 31Kraljevic D, Vukojevic K, Karan D, et al. Proliferation, apoptosis and expression of matrix metalloproteinase-9 in human fetal lung. Acta histochem. 2015; 117: 444-450.
- 32Prusac IK, Zekic Tomas S, Roje D. Apoptosis, proliferation and Fas ligand expression in placental trophoblast from pregnancies complicated by HELLP syndrome or pre-eclampsia. Acta Obstet Gynecol Scand. 2011; 90: 1157-1163.
- 33Sakaguchi S. Naturally arising Foxp3-expressing CD25+CD4+ regulatory T cells in immunological tolerance to self and non-self. Nat Immunol. 2005; 6: 345-352.
- 34Wilczynski JR, Kalinka J, Radwan M. The role of T-regulatory cells in pregnancy and cancer. Front Biosci. 2008; 13: 2275-2289.
- 35Tang Q, Bluestone JA. The Foxp3+ regulatory T cell: a jack of all trades, master of regulation. Nat Immunol. 2008; 9: 239-244.
- 36Toldi G, Švec P, Vásárhelyi B, et al. Decreased number of FoxP3+ regulatory T cells in preeclampsia. Acta Obstet Gynecol Scand. 2008; 87: 1229-1233.
- 37Rahimzadeh M, Norouzian M, Arabpour F, Naderi N. Regulatory T-cells and preeclampsia: an overview of literature. Expert Rev Clin Immunol. 2016; 12: 209-227.
- 38Tilburgs T, Scherjon SA, van der Mast BJ, et al. Fetal-maternal HLA-C mismatch is associated with decidual T cell activation and induction of functional T regulatory cells. J Reprod Immunol. 2009; 82: 148-157.
- 39Hu X, Wang Y, Mor G, Liao A. Forkhead box P3 is selectively expressed in human trophoblasts and decreased in recurrent pregnancy loss. Placenta. 2019; 81: 1-8.
- 40Cohen JM, Beddaoui M, Kramer MS, Platt RW, Basso O, Kahn SR. Maternal antioxidant levels in pregnancy and risk of preeclampsia and small for gestational age birth: a systematic review and meta-analysis. PLoS One. 2015; 10:e0135192.
- 41Crispi F, Dominguez C, Llurba E, Martin-Gallan P, Cabero L, Gratacos E. Placental angiogenic growth factors and uterine artery Doppler findings for characterization of different subsets in preeclampsia and in isolated intrauterine growth restriction. Am J Obstet Gynecol. 2006; 195: 201-207.
- 42Redman CW, Sargent IL. Immunology of pre-eclampsia. Am J Reprod Immunol. 2010; 63: 534-543.
- 43Orlovic M, Tomic V, Vukojevic K, et al. Decreased expression of MMP-9 in CD8(+) cells in placenta with severe preeclampsia. Biotec Histochem. 2017; 92: 288-296.
- 44Hamilton SA, Tower CL, Jones RL. Identification of chemokines associated with the recruitment of decidual leukocytes in human labour: potential novel targets for preterm labour. PLoS One. 2013; 8:e56946.
- 45Kisielewicz A, Schaier M, Schmitt E, et al. A distinct subset of HLA-DR+-regulatory T cells is involved in the induction of preterm labor during pregnancy and in the induction of organ rejection after transplantation. Clin Immunol. 2010; 137: 209-220.