Macrophages (M1/M2 ratio) in the endometrium at follicular and secretory phases and deciduae from normal, abnormal pregnancies and recurrent spontaneous abortions in human
Date Issued
2015
Date
2015
Author(s)
Tsao, Fang-Yu
Abstract
In mammals, the developing embryo-placenta unit is considered as a semi-allogeneic graft. Maternal immunomodulation allows the acceptance and growth of the fetus without being rejected in the uterus. Immune cells in decidua, holding a key role during the implantation, not merely keep maternal immunomodulation but also maintain defense of host and fetus against pathogens. Decidual macrophages represent the second largest proportion of leukocyte in the uterus so their roles in maintaining maternal tolerance shall not be overlooked and are the main target cells in this study. Macrophages might be polarized to M1 or M2 subpopulations by the stimulation from uterine microenvironment, especially those hormones and cytokines during implantation in early pregnancy. The imbalance of M1/M2 might link to pathological pregnancies. Clinically, some women, healthy but refractory to traditional therapies, suffered from unexplained recurrent spontaneous abortions without defined etiologies. Hence, our goal is to evaluate the M1/M2 ratio in vivo the condition of hormone fluctuation during different menstrual phases and various groups of women with normal and abnormal pregnancies and recurrent spontaneous abortions with immunofluorescence studies to find out the possible pathophysiology of abortions. The results demonstrated that M1 macrophages are abundant in abnormal pregnancies and RSA and the frequency of M2 macrophages is significantly higher in luteal phase and normal pregnancies. It suggested that M2 macrophage may be the imperative role in preparing for and upholding pregnancy and that high level of M1 macrophages may induce spontaneous abortions due to promoting excessive inflammation. This study may provide directions for developing new treatment and the level of M1/M2 in the future might be the predictor of pregnancy outcome in women with unexplained abortion.
Subjects
M1/M2 Macrophages
decidual macrophages
maternal immunomodulation
recurrent spontaneous abortion
SDGs
Type
thesis
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