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Unexplained fetal death has a biological signature of maternal anti-fetal rejection: chronic chorioamnionitis and alloimmune anti-human leucocyte antigen antibodies.
MedLine Citation:
PMID:  22092404     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Lee J, Romero R, Dong Z, Xu Y, Qureshi F, Jacques S, Yoo W, Chaiworapongsa T, Mittal P, Hassan S S & Kim C J (2011) Histopathology  59, 928-938 Unexplained fetal death has a biological signature of maternal anti-fetal rejection: chronic chorioamnionitis and alloimmune anti-human leucocyte antigen antibodies Aims:  Chronic chorioamnionitis is a histological manifestation of maternal anti-fetal cellular rejection. As failure of graft survival is the most catastrophic event in organ transplantation, we hypothesized that fetal death could be a consequence of maternal rejection. The aim of this study was to assess whether there is evidence of cellular and antibody-mediated rejection in fetal death. Methods and results:  Placental histology was reviewed for the presence of chronic chorioamnionitis in unexplained preterm fetal death (n = 30) and preterm live birth (n = 103). Amniotic fluid CXCL10 concentrations were measured with a specific immunoassay. Chronic chorioamnionitis was more frequent in fetal death than in live birth (60.0% versus 37.9%; P < 0.05) and fetal death had a higher median amniotic fluid CXCL10 concentration than live birth (2.0 versus 1.8 ng/ml, P < 0.05), after adjusting for gestational age at amniocentesis. Maternal anti-human leucocyte antigen class II panel-reactive seropositivity determined by flow cytometry was higher in fetal death compared to live birth (35.7% versus 10.9%; P < 0.05). Conclusions:  Chronic chorioamnionitis is a common pathologic feature in unexplained preterm fetal death. This novel finding suggests that cellular and antibody-mediated anti-fetal rejection of the mother is associated with fetal death (graft failure) in human pregnancy.
Authors:
Joonho Lee; Roberto Romero; Zhong Dong; Yi Xu; Faisal Qureshi; Suzanne Jacques; Wonsuk Yoo; Tinnakorn Chaiworapongsa; Pooja Mittal; Sonia S Hassan; Chong Jai Kim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Histopathology     Volume:  59     ISSN:  1365-2559     ISO Abbreviation:  Histopathology     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704136     Medline TA:  Histopathology     Country:  England    
Other Details:
Languages:  eng     Pagination:  928-38     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Limited.
Affiliation:
Perinatology Research Branch, NICHD/NIH/DHHS Department of Obstetrics and Gynecology, Wayne State University School of Medicine Center for Molecular Medicine and Genetics, Wayne State University School of Medicine Department of Pathology, Wayne State University School of Medicine Translational Research and Clinical Epidemiology, Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA.
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