Altered protease expression by periarterial trophoblast cells in severe early-onset preeclampsia with IUGR.

Adaptation of uteroplacental arteries in patients with early-onset preeclampsia combined with IUGR is compromised due to insufficient invasion of extravillous trophoblast cells (EVT) into the spiral artery wall. The underlying molecular mechanisms are widely unknown. We investigated expression and possible mechanisms of regulation of different matrix-metalloproteases (MMPs) by EVT in placental bed biopsies from patients with early onset preeclampsia combined with IUGR and healthy pregnant women.

[Immunologic and tumor biology aspects of placentation in humans].

In this survey, findings relating to the control of infiltration by the cytotrophoblast during human placentation are reviewed, with particular reference to immunology and tumour biology. Possible effects on pregnancy and parturition due to failure of the regulatory processes involved in placentation are discussed.

A subset of CD56+ large granular lymphocytes in first-trimester human decidua are proliferating cells.

Objective: To determine whether the unusually high number of CD56+ large granular lymphocytes (LGL) in the decidua of early human pregnancy arises from selective migration or in situ proliferation.

Design: Controlled clinical study.

Setting: Academic research environment.

[Placentation in the human: a transplantation or tumor model?].

In human placentation, anchoring villi develop to attach the placenta to the wall of the uterus. This attachment is brought about by extensive infiltration of the maternal tissue by cytotrophoblast cells of fetal origin. As trophoblast cells do not express classical histocompatibility antigens (HLA antigens), increasing doubt has been cast upon the "transplantation" model of pregnancy.

Interleukin-12- and interleukin-2-stimulated release of interferon-gamma by uterine CD56++ large granular lymphocytes is amplified by decidual macrophages.

Numerous studies have suggested that interferon-gamma (IFN-gamma) exhibits an inhibitory effect on conceptus development during pregnancy, and recent investigations have shown that decidual CD56++, CD16- large granular lymphocytes (LGL) contain mRNA for IFN-gamma. We have investigated the influence of exogenous interleukin-12 (IL-12) and interleukin-2 (IL-2) on IFN-gamma secretion by cultivated LGL and macrophages isolated from first trimester human decidua. The effect of decidual macrophages on IFN-gamma secretion by LGL was also assessed using co-incubation experiments.

Immune Sensitization to the 60 kD Heat Shock Protein and Pregnancy Outcome.

Heat shock proteins are highly conserved proteins present in organisms ranging from bacteria to man. They are both dominant microbial immunogens and among the first proteins produced during mammalian embryo development. Since bacterial and human heat shock proteins share a high degree of amino acid sequence homology, it has been suggested that sensitization to bacterial heat shock proteins during an infection may result in autoimmunity to human heat shock proteins.

An accurate method for sonographic estimation of the weight of very preterm fetuses.

This study was undertaken to test the accuracy of formulas we recently developed for the sonographic estimation of the weight of very preterm fetuses. The formulas were used to determine estimated weights from prenatal sonographic data for 62 premature infants born at 23-29 weeks of gestation, weight < or = 1,400 g. The mean absolute deviation of the actual birth weight from the estimated weight was 75.

Recurrent first trimester spontaneous abortion associated with antiphospholipid antibodies: a pilot study of treatment with intravenous immunoglobulin.

Background: Antiphospholipid antibodies, unassociated with an underlying connective tissue disease, have repeatedly been detected in women suffering from recurrent spontaneous abortions. Several therapeutic regimens have been advocated for pregnant women with recurrent fetal loss and antiphospholipid antibodies. However, most of these approaches were empirical, using several drugs simultaneously, and most reports describe single cases or limited series.

Immunohistochemical localization of tissue inhibitor of metalloproteinases-2 (TIMP-2) in first trimester human placental decidua.

Background: Matrix metalloproteinases have been shown to play an important role both in the invasive growth of malignant tumors and in human placentation. However, unlike tumor cell invasion, cytotrophoblast invasion is strictly controlled in its extent. Tissue inhibitors of metalloproteinases (TIMP) may play an important role in the modulation of cytotrophoblast growth into maternal tissue.

The distribution of tissue inhibitor of metalloproteinases-2 (TIMP-2) in the human placenta.

Matrix metalloproteinases (MMPs) secreted by human cytotrophoblasts are crucial for the invasion of the placental bed by these cells. The invasive growth of the trophoblast is similar to that of malignant tumours in many respects, but, unlike the latter, it is strictly controlled. Tissue inhibitors of metalloproteinases (TIMPs) have been postulated to play a role in the control of trophoblast invasion.

[Diagnosis and therapy of fetal alloimmune thrombocytopenia].

In fetal alloimmune thrombocytopenia, maternal IgG antibodies directed against platelets pass into the fetal circulation and lead to the destruction of fetal platelets. Fetal thrombocytopenia is usually first noted postnatally, but the maternal alloantibodies may lead to severe fetal haemorrhage in utero in the second or, more commonly, third trimester. Platelet-specific antibodies appear to play the major role in the pathogenesis of fetal alloimmune thrombocytopenia.

Comparative analysis of the immunophenotypes of decidual and peripheral blood large granular lymphocytes and T cells during early human pregnancy.

Problem: The functional role of the leukocytes in the decidual is not clear. They may regulate the maternal immune response to the fetal allograft. However, the factors controlling maternal and fetal communication have not yet been identified.

[Functional significance of CD56 large granular lymphocytes in the decidua in early pregnancy in the human].

Objective: The study was undertaken to characterize the large granular lymphocytes (LGL) found in large numbers in the decidua of early pregnancy, in order to investigate their functional significance in placentation.

Methods: The LGL were investigated by immunohistochemical, flow cytometric and molecular biological techniques.

Results And Conclusions: The LGL resemble a small subpopulation of Natural Killer cells (NK-cells) in the peripheral blood, express activation antigens and produce cytokines that may have a regulatory/modulatory influence on trophoblast growth.

A new formula for prenatal ultrasonographic weight estimation in extremely preterm fetuses.

A new formula for the prenatal estimation of the weight of extremely preterm fetuses was derived using ultrasound measurements and birth weights of 73 premature infants delivered before 30 completed weeks of pregnancy and weighing between 400 and 1,680 g at birth. The actual birth weight lay within +/- 15% of the estimated weight calculated with this formula in 92% of the cases. Preliminary testing of the reliability of the formula was performed on a further test group of 19 nonselected cases.

Expression of the p53 tumour suppressor gene in human placenta: an immunohistochemical study.

Since human trophoblast undergoes extensive proliferation and exhibits invasive growth comparable to that of a malignant tumour, human placenta at various different stages of gestation was investigated immunohistochemically with the monoclonal antibody Ab-6 for expression of the p53 tumour suppressor gene. p53 protein was detected in the nuclei of a few trophoblastic cells, almost all belonging to the cytotrophoblast and only very few to the syncytiotrophoblast, in nearly all specimens investigated (first trimester 10/10, second trimester 5/5, third trimester 4/5). First trimester trophoblast exhibited increased expression of p53 protein in the juxtastromal areas of cytotrophoblast cell islands and columns, that is, in areas where high proliferative activity and increased expression of the epidermal growth factor receptor have been described in the literature.

A new insufflation needle with a special optical system for use in laparoscopic procedures.

A new insufflation needle with a special optical system consisting of a transparent, conical tip, to which an endoscope can be attached, allows perforation of the abdominal wall under direct vision. A video camera can be attached to the instrument, so that its progress through the abdominal wall can be observed on a monitor. The danger of damage to vessels and intra-abdominal organs associated with blind insertion of the insufflation needle is thus avoided.

Distribution of cell adhesion molecules in decidua of early human pregnancy. An immunohistochemical study.

Background: The aim of the study was to investigate human decidua for cell adhesion molecules involved in interactions between the various different maternal and fetal cell populations, homing of the unusual intradecidual population of CD56+ lymphocytes, and organization of the decidual extracellular matrix.

Experimental Design: First trimester human decidua from normal pregnancies was investigated immunohistochemically with antibodies against integrin subunits (alpha 1-6, alpha L, alpha M, alpha X, alpha IIb, alpha V, beta 1, beta 3, and beta 4), platelet-endothelial cell adhesion molecule, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, and L-selectin.

Results: Endometrial glands stained for alpha 1, alpha 2, alpha 3, alpha 5, alpha 6, alpha V, beta 1, beta 3, and beta 4, and stromal cells for alpha 1, alpha 3, alpha 5, alpha 6, alpha V, beta 1, beta 3, ICAM-1, and VCAM-1.

[Condylomata acuminata in pregnancy. Is there an indication for Cesarean section?].

Condylomata acuminata are very rare in children, although the prevalence of clinically or cytologically visible human papilloma virus infections is high. We report on a 28-year old G IV, P II with genital warts at the time of delivery, who had a baby boy without any signs of HPV-infection. The condylomata of the mother persisted, and subsequently laser vaporisation was performed one year after delivery.