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The placental bed of patients with preeclampsia has increased density of granulysin positive immunocytes

      Objective

      Granulysin, a novel cytolytic molecule of natural killer cells and cytotoxic T lymphocytes, induces cell-mediated apoptosis in mammalian cells and has antimicrobial properties. Granulysin mRNA expression is increased during acute allograft rejection and the serum granulysin level is increased in preeclampsia. This has been interpreted as supporting evidence of an abnormal allogeneic response biased toward a Th-1 type response (Clin Exp Immunol 2004; 136:114). This study was conducted to characterize the expression of granulysin in the fetomaternal interface (placental bed) of women with and without preeclampsia.

      Study design

      Placental bed biopsies were obtained from patients with: (1) preterm delivery and intact membranes (PTD) without chorioamnionitis (n = 15); and (2) preterm severe pre-eclampsia (n = 15). Patients were matched for gestational age. Granulysin and CD3 (T cell marker) expressions were determined in the placental bed using double immunohistochemistry. Image analysis to determine the number of granulysin positive cells was conducted in 10 microscopic fields (×400). Non-parametric statistics were employed for analysis.

      Results

      (1) Granulysin was present in scattered mononuclear cells and polymorphonuclear leukocytes in the decidua basalis, the myometrium and vascular wall in the placental bed. (2) The median number of granulysin positive cells was significantly higher in patients with preeclampsia than in patients without preeclampsia (P < .0001). (3) The median number of granulysin- / CD3+ T lymphocytes was significantly lower in patients with preeclampsia than in those without preeclampsia (P = .0001).

      Conclusion

      The number of granulysin positive immunocytes is increased in the placental bed of women with preeclampsia. These results suggest the presence of an exaggerated Th-1 immune response at the feto-maternal interface in patients with preeclampsia.