Sequestration of anti-Cra in the placenta: serologic demonstration by placental elution (original) (raw)
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Binding of pathogenic ligands by human placental erythrocytes
Bulletin of Experimental Biology and Medicine, 1992
Fc-receptors for IgG are located on the surface of the membranes of many peripheral blood cells including T and B lymphocytes, monocytes, macrophages, and polymorphonuclear leukocytes [2, 13]. More recently Fc-receptors have also been found on erythrocyte membranes [15]. A detailed study of the role of Fc-receptors has shown that the main function of these formations is to remove from the circulation only aggregated IgG or immune complexes [2]. Their formation is linked with interaction between antibody and antigen, which under normal conditions are eliminated. If for some reason or other this does not happen, these pathological formations can lead to the development of disease: renal damage, or autoimmune diseases [6]. During binding of immune complexes with Fc-receptors, the cells release neutral and acid hyclrolases, metabolites of amino acids such as prostagtandins, and leukotrienes [12]. If macrophages are activated, active forms of oxygen are produced [5]. Meanwhile, as a result of attachment of immune complexes or aggregated immunoglobulins to erythrocytes no activating processes of any kind are observed. It has been shown that the main role in ridding the serum of immune complexes is played by macrophages. These experimental data also have been confirmed by clinical observations [11]. However, despite the large number of investigations which had indicated the essential role of blood ceils in these processes in pregnant women, the question of the role of erythrocytes in adsorption of pathogenic ligands has not yet been fully explained.
Journal of medical case reports, 2015
This report describes the challenges of treating a pregnant woman who had a rare case of critical placenta accreta with concurrent Cromer system anti-Tc(a) and anti-Kidd A alloantibodies. No previous case of such alloimmunization in a patient with placenta accreta has been reported. A 28-year-old African woman with anti-Cromer Tc(a) antibodies, anti-Kidd A antibodies and placenta accreta was admitted to the obstetric emergency department at our university hospital with persistent vaginal bleeding. Her rare Cromer blood group system antibodies had been diagnosed 1 month earlier; no compatible blood had been found despite a worldwide search. We performed a cesarean section after placement of Fogarty balloons in her uterine arteries with preoperative endovascular interventional radiology. Other therapeutic interventions included preoperative iron administration to raise hemoglobin and the scheduled predeposit of autologous blood. Intraoperative therapeutic management was aimed at preve...
The complement system in the pathophysiology of pregnancy
Molecular Immunology, 2006
A fully active complement system deriving from the maternal circulation as well as from local production by various cell source is present in the placenta. The role of this system at the placental level, as in any other tissue in the body, is to protect both the fetus and the mother against infectious and other toxic agents. As fetal tissues are semi-allogeneic and alloantibodies commonly develop in the mother, the placenta is potentially subject to complement-mediated immune attack at the feto-maternal interface with the potential risk of fetal loss. Uncontrolled complement activation is prevented in successful pregnancy by the three regulatory proteins DAF, MCP and CD59 positioned on the surface of trophoblasts. The critical role played by these complement regulators is supported by the embryonic lethality observed in mice deficient in the complement regulator Crry.
RU 486 Mediated Leukocytic Inflammatory Reaction at the Utero-Placental Interface
Asia-Oceania Journal of Obstetrics and Gynaecology, 1989
Placentae obtained from RU 486 treated cynomolgus monkeys, with successful pregnancy outcome, could not be distinguished, by microscopic or macroscopic examination, from normal placental morphology of untreated females. However, circulating PAPP-A levels were markedly depressed in RU 486 treated (114.8k13.1 IUjZ) than in control animals (477.2 zk 150 IU/Z), suggesting compromised placental physiology. Microscopic examination of placental tissue obtained from animals with fetal demise, after RU 486 administration, revealed pathological changes. When fetal demise occurred recently (< 24 h), active villus destruction by infiltrating polymorphonuclear leukocytes was readily observed. Whereas aqueous extracts of placentae, whether obtained by cesarean section or spontaneous delivery, inhibited neutrophil elastase (HGE) activity, extracts of placenta being degraded by host phagocytic-proteolytic defense system were rich in HGE activity. Thus suggesting that parturition was not mediated by leukocyte lysosomal proteases, such as HGE, and that hemochorrially implanted placentae produce PAPP-A, a specific inhibitor of HGE. Administration of RU 486 decreased placental PAPP-A production and secretion, culminating with a neutrophilic infiltration into placental intervillous blood spaces, destruction of villus structure and fetal demise.
Indian Journal of Obstetrics and Gynecology Research, 2023
Background: Contrary to well-established guidelines in developed countries, awareness regarding red cell alloantibodies in antenatal period are lacking in India. Investigating for indirect antiglobulin test (IAT) is mostly limited to the Rh D negative antenatal cases. This case series revisits this vital aspect of maternal and fetal safety. Instances of alloantibody other than anti-D are reported. Materials and Methods: Study was done in Transfusion Medicine department of a tertiary care hospital in North India during 2019-2020. IAT was performed not during the 1st or 2nd trimesters of pregnancy but as a routine compatibility test during delivery. Patients with positive IAT were further evaluated for the detection of alloantibody by using identification panel red cells. Result: Eight antenatal cases with irregular antibodies other than anti-D during 2019-2020 are described. Antibodies detected per patient were single (three cases of anti-E, one of anti-Fya, one of anti-M) or multiple (two cases of anti-E plus anti-c, one of anti-E plus anti-K). Direct antiglobulin test of four babies born to these mothers was found to be positive, one of whom was still born and rest recovered with medical management. Two other babies had DAT negative and two mothers presented late after still birth. Alloantibody titer indicated in patient with anti-E during mid-pregnancy had titer was undetectable by standard tube technique. Conclusion: Non anti-D alloantibodies can potentially affect fetus, asserting equal attention as anti-D. IAT should not be missed in pregnancy as it is common to investigations for compatibility as well as for fetal wellbeing assessment. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Increasing of Syncytial Knot and Fibrinoid Deposit in High-Cd Accumulated Human Placentas
International Journal of Morphology, 2013
A toxic metal, cadmium (Cd), can accumulate in human organs. Placenta is usually used as indicator organ for Cd exposure. Therefore, we aim to investigate the different of placental morphology between the low-and high-Cd accumulated placentas. The samples were collected from 14 pregnant women who resided in low-Cd contaminated (L-Cd group) and high-Cd contaminated (H-Cd group) areas. The concentrations of Cd in blood (B-Cd), urine (U-Cd) and placentas (P-Cd) were measured by ICP-MS and AAS. The morphological appearance of placentas was examined by using routine paraffin section and H & E staining. The results showed that levels of B-Cd, U-Cd and P-Cd were significantly higher in H-Cd group than in L-Cd group (p= 0.001). Moreover, the B-Cd was positively correlated with U-Cd (rs= 0.823, p= 0.000) and P-Cd concentrations (rs= 0.854, p= 0.000). The appearances of syncytial knot (STK) and fibrinoid deposit (Fd) were obviously greater in H-Cd group than in L-Cd group (p= 0.007, p= 0.026). The STK was positively correlated with both Fd (rs= 0.572, p= 0.032) and P-Cd concentration (rs= 0.766, p= 0.001). Although the chorioamnitis and decidual inflammation features were found in both groups but the appearance in H-Cd group seems to be more severe than in L-Cd group. From these results, we suggested that high Cd level in placenta may be involved in morphological changes, especially STK and Fd increasing and probably disturb the connection between maternal and fetal circulation.
Maternal anti-placental reactivity in natural, immunologically-mediated fetal resorptions
Journal of Immunology, 1994
Observations on maternal recognition of the fetus and the demonstration of the effects of cytokines on reproductive events led to the "immunotrophism" model, which suggests that maternal immune recognition of fetally-derived Ags results in the release of cytokines that promote the growth of the placenta; any disturbance in this balance of cytokines could result in deleterious consequences for the placenta and, in turn, the fetus. We have focused our attention on the murine CBNJ X D B N 2 model of spontaneous abortions and compared them with normal CBA X BALB/c pregnancies. Our results indicate that the extent of stimulation of maternal strain lymphocytes in response to stimulator placental cells in mixed lymphocyte-placenta reactions (MLPR) was much higher in the normal mating combination compared with the abortion-prone mating combination. Cytokine analysis of the supernatants from MLPR indicates that there is significantly higher production of TNF-a, IFN-y, and IL-2 in supernatants from the abortion-prone combination than in supernatants from the normal combination. Furthermore, MLPR-stimulated cells induce resorptions in normal pregnant mice; maternal strain lymphocytes stimulated by placentas from the abortion-prone combination induce high rates of fetal resorptions, but lymphocytes stimulated with placentas from the normal combination do not. Together, these results suggest that immunologically mediated fetal resorptions probably result from improper or inappropriate maternal responses to placental Ags. Our observations also suggest that such effects are probably mediated by cytokines.
Receptor-mediated uptake and transport of macromolecules in the human placenta
The International Journal of Developmental Biology, 2010
The human placenta is required to be the anchor, the conduit and the controller during pregnancy. The survival of the baby and its associated placenta is dependent upon the placenta shielding the embryo/fetus from harm, e.g., autoimmune disease -thrombophilia, antiphospholipid syndrome or infections, while simultaneously providing for the passage of critical nutrients (e.g., amino acids, vitamins) and beneficial immunoglobulins. In a number of instances, the movements of macromolecules into and through the placenta can result in the passage of the intact molecules into the fetal circulation or in the case of proteins -catabolism to amino acids which are utilized by the placenta and the fetus for continued growth and development. The transfer of two such macromolecules, immunoglobulin G (IgG) and vitamin B12 (cyanocobalamin or B12), are examined as to the unique receptor-mediated transfer capability of the human placenta, its transfer specificity as related to specific receptors and the role of endogeneous placental proteins (trancobalamins) in facilitating the recognition and transport of specifically B12. Brief comparisons will be made to other animal species and the differences in specific organ transfer capabilities.