Objective
During an uncomplicated pregnancy the conceptus is a semiallogeneic entity in which
rejection is prevented by suppression of the maternal immune system. We hypothesized
that this suppression is disturbed in patients with preeclampsia and that a maternal
immune response to fetal (foreign/paternal) antigens in the fetal-maternal interface
may be responsible for local inflammation, with subsequent endothelial dysfunction
and systemic disease.
Study Design
Blood samples were obtained from 14 women with preeclampsia (cases), 14 gestational-age
and parity-matched women with uncomplicated pregnancies (controls), and their partners.
We determined the partner-specific cytotoxic T-lymphocyte precursor frequency (CTLpf)
and the CTLpf directed to unrelated partners with uncomplicated pregnancies. We measured
the CTLpf in peripheral blood mononuclear cells (PBMCs) from cases and controls using
limited-dilution assays. In addition, proliferation was tested in a mixed-lymphocyte
culture (MLR).
Results
The partner-specific CTLpf was significantly higher in cases compared with controls
(median, 183 [15-338] vs 67 [9-232] per million PBMCs, P = .02). In contrast, in women with uncomplicated pregnancies, the partner-specific
CTLpf was down-regulated compared with the CTLpf directed to an unrelated partner
who fathered uncomplicated pregnancies (P = .02). No difference was found in partner-specific MLR response between cases and
controls.
Conclusion
These results suggest that women with preeclampsia have a higher cytotoxic T-cell
response to paternal antigens compared with pregnant controls. This insufficiently
suppressed immune response may eventually lead to the development of preeclampsia.
Key words
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Article info
Publication history
Published online: August 19, 2010
Accepted:
June 17,
2010
Received in revised form:
June 1,
2010
Received:
March 17,
2010
Footnotes
C.J.M.d.G. was a clinical fellow of Nederlandse Organisatie voor Gezondheisonderzoek en Zorginnovatie, Dutch National Research Institute.
The first 2 and the last authors contributed equally to the study and article.
Cite this article as: de Groot CJM, van der Mast BJ, Visser W, et al. Preeclampsia is associated with increased cytotoxic T-cell capacity to paternal antigens. Am J Obstet Gynecol 2010;203:496.e1-6.
Identification
Copyright
© 2010 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
