An Immunological Basis for Chronic Histiocytic Intervillositis in Recurrent Fetal Loss
Article first published online: 24 APR 2013
© 2013 John Wiley & Sons Ltd
American Journal of Reproductive Immunology
Volume 70, Issue 3, pages 230–237, September 2013
How to Cite
An immunological basis for chronic histiocytic intervillositis in recurrent fetal loss. Am J Reprod Immunol 2013; 70: 230–237, , , , , , , , .
- Issue published online: 7 AUG 2013
- Article first published online: 24 APR 2013
- Manuscript Accepted: 20 MAR 2013
- Manuscript Received: 2 NOV 2012
- Adverse pregnancy outcome;
- chronic histiocytic intervillositis;
Chronic histiocytic intervillositis (CHIV) is a rare type of placental pathology that is associated with reproductive loss at all gestational ages. The aim of the study was to investigate the relationship between the severity of CHIV and the outcome of pregnancy and to compare the immune response between CHIV patients and controls to explore an immunological origin of CHIV.
Method of study
Microscopic slides were reviewed and scored according to a previously published grading system in 30 pregnancies of 22 CHIV patients. Partner-specific mixed lymphocyte reactions, cytotoxic T-lymphocyte precursor frequencies (CTLpf), and anti-HLA antibodies were determined in four patients and seven controls.
Higher CHIV scores are associated with worse pregnancy outcome. CHIV patients demonstrated a higher CTLpf against their partner compared to non-complicated pregnancies (P = 0.03). The CTLpf was extremely high in 75% of the patients. Antipaternal HLA antibodies were only present in 75% of the CHIV patients compared to none of the controls (P = 0.02).
CHIV scores seem to be associated with the severity of adverse pregnancy outcome. High antipaternal cellular (T-cell) and humoral (B-cell) response to partner-specific CTLpf and the presence of anti-HLA antibodies directed to the partner suggest an immunologic origin of CHIV.