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首页> 外文期刊>Journal of Reproductive Immunology >The distribution of immune cells and macrophages in the endometrium of women with recurrent reproductive failure I: Techniques.
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The distribution of immune cells and macrophages in the endometrium of women with recurrent reproductive failure I: Techniques.

机译：复发性生殖衰竭妇女子宫内膜中免疫细胞和巨噬细胞的分布I：技术。

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Recurrent miscarriage affects approximately 1% of the population and in half of these cases no cause is found. Abnormally functioning immunocompetent cells, including natural killer (NK) cells, in the endometrium, are thought to be responsible for many such cases and treatment trials including oral prednisolone and intravenous immunoglobulins are now underway. Despite these encouraging developments, there is neither adequate standardization of counting uterine NK cells nor consensus as to what constitutes an abnormal level. To address this issue, immunohistochemistry was used to examine the presence and distribution of selected immune cells and macrophages in the endometrium from 222 women who had a routine endometrial biopsy for investigation of recurrent miscarriage or IVF failure, at various stages of the menstrual cycle, and accessioned prospectively over a 7-month period. Biopsies were examined by H+E and immunostained for CD8(+) T-cells, CD163(+) macrophages, CD56(+) NK cells, and CD57(+) cells. Cell numbers (expressed as immunopositive cells per mm(2)) were determined in the stroma of the functional layer of endometrium and the relative concentrations of some cell types (CD163(+) macrophages, CD56(+) NK cells) were expressed as a percentage of all stromal cells. Routine H+E sections revealed 12 patients with focal endometritis aggregates in most instances, and non-random but scattered cells in all cases, with a twofold increase in the luteal phase. CD163(+) cells were distributed evenly throughout the superficial endometrial stroma and also present as single or clustered macrophages within the lumens of superficial glands, mostly in the luteal phase. CD56(+) NK cells showed "diffuse" but variable distribution throughout the functional layer and perivascular aggregates of various sizes in two thirds of cases. Raw cell counts were low and relatively stable in the proliferative phase, but increased somewhat during the first half of the secretory phase, while in the second half of secretory phase they increased six to tenfold. Percentage counts rose from approximately 5% of stromal cells in the early part of the secretory phase of the cycle to over 35% in premenstrual endometrium. CD57(+) cells were present in very low numbers in most cases. The study illustrates the complexity and variability of immune cell infiltration of endometrium. We stress the need for strict counting protocols and attention to histological criteria if any immunological perturbations potentially responsible for recurrent reproductive failure are to be identified. Reference ranges for individual cell types are only valid for individual "days" of a normalized menstrual cycle.
机译：反复流产影响约1％的人口，在这些情况的一半中，没有发现原因。子宫内膜中异常正常的免疫功能细胞，包括自然杀伤（NK）细胞，被认为是造成许多此类病例的原因，目前正在进行包括口服泼尼松龙和静脉内免疫球蛋白在内的治疗试验。尽管取得了这些令人鼓舞的进展，但对子宫NK细胞计数的标准化还不够，也没有关于异常水平的共识。为了解决这个问题，采用免疫组织化学方法检查了222名经常规子宫内膜活检的妇女子宫内膜中某些免疫细胞和巨噬细胞的存在和分布，这些妇女在月经周期的各个阶段进行了反复的流产或IVF衰竭研究，并且在7个月内预期加入。通过H + E检查活检组织，并对CD8（+）T细胞，CD163（+）巨噬细胞，CD56（+）NK细胞和CD57（+）细胞进行免疫染色。在子宫内膜功能层的基质中测定细胞数（表示为每mm（2）的免疫阳性细胞），并将某些细胞类型（CD163（+）巨噬细胞，CD56（+）NK细胞）的相对浓度表示为所有基质细胞的百分比。常规H + E切片显示，大多数情况下有12例患者局灶性子宫内膜炎聚集，所有情况下均非随机但散在的细胞，黄体期增加了两倍。 CD163（+）细胞均匀分布在整个浅层子宫内膜间质中，也以单个或成簇的巨噬细胞形式存在于浅腺腔内，主要在黄体期。在三分之二的病例中，CD56（+）NK细胞显示出“扩散”但分布在整个功能层和各种大小的血管周围聚集体中。原细胞计数低，在增生期相对稳定，但在分泌期的前半段有所增加，而在分泌期的后半段则增加了六到十倍。百分比计数从周期分泌阶段初期的约5％基质细胞上升到月经前子宫内膜的35％以上。在大多数情况下，CD57（+）细胞的数量很少。该研究说明子宫内膜免疫细胞浸润的复杂性和变异性。如果要确定可能导致复发性生殖衰竭的任何免疫学扰动，我们强调必须进行严格的计数方案并注意组织学标准。各个细胞类型的参考范围仅对正常月经周期的各个“天”有效。

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