Document Detail

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:  MEDLINE    
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.
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; Research Support, N.I.H., Intramural    
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:  2012-03-06     Revised Date:  2013-06-27    
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.
Perinatology Research Branch, NICHD/NIH/DHHS, USA.
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MeSH Terms
Amniotic Fluid / chemistry,  immunology*
Autoantibodies / blood
Autoantigens / immunology*
Chemokine CXCL10 / immunology
Chorioamnionitis / blood,  immunology*,  pathology
Enzyme-Linked Immunosorbent Assay
Fetal Death / immunology*,  pathology
Flow Cytometry
HLA Antigens / immunology*
Young Adult
Grant Support
Reg. No./Substance:
0/Autoantibodies; 0/Autoantigens; 0/Chemokine CXCL10; 0/HLA Antigens

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