Peri-implantation cytokine profile differs between singleton and twin IVF pregnancies.

PROBLEM: It is unknown whether maternal cytokine production differs between twin and singleton gestations in the implantation phase. A difference in maternal serum cytokine concentrations in twins would imply a dose-response to the invading embryos, as opposed to a general immune reaction. METHOD OF STUDY: A prospective longitudinal cohort of women aged 18-45 at an academic fertility center undergoing in vitro fertilization and embryo transfer (IVF-ET) underwent routine collection of serial serum samples starting 9 days after ET and then approximately every 48 hours thereafter. Cryopreserved aliquots of these samples were assayed for interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), and C-X-C motif chemokine ligand 10 (CXCL10) using the SimplePlex immunoassay platform. Pregnancies were followed until delivery. Serial measures of serum concentrations of IL-10, CXCL10, and TNF-α in singleton or di-di twin pregnancies from 9 to 15 days after IVF-ET were compared. RESULTS: Maternal serum levels of CXCL10 are significantly lower in women with di-di twin pregnancies in early implantation compared to those with singleton gestation (day 9-11, P = .02). Serum levels of TNF-α and IL-10 were comparable at all studied time points (P > .05). CONCLUSION: Maternal serum levels of CXCL10 are significantly lower in the earliest implantation phase in di-di twins compared to singleton conceptions. Given the known anti-angiogenic role of CXCL10, we hypothesize that lower CXCL10 levels in twin implantations allow an environment that is conducive for the greater vascularization required for the establishment of dual placentation in di-di twins.

Characterization of regulatory T cells in decidua of miscarriage cases with abnormal or normal fetal chromosomal content.

Decreased regulatory T (Treg) cells have been reported in cases of recurrent pregnancy loss. To understand the role of Treg cells in human pregnancy, we have studied the frequency, localization and characterization of Treg cells in the decidua. The frequency of Foxp3(+) cells among CD3(+)CD8(-) cells at the decidua basalis in cases of miscarriage with a normal embryo karyotype (n=10) was significantly lower than in normally progressing pregnancies (n=10). However, those frequencies in miscarriage with an abnormal embryo karyotype were similar to normally progressing pregnancies. Next, we used flow cytometry to study Treg cell expression of the proliferation marker Ki67 and functional Treg marker CCR5. The frequency of Foxp3(+)CD4(+) T cells in miscarriage with a normal embryo (n=10) was significantly lower than those in normally progressing pregnancies (n=15) and in miscarriage with an abnormal embryo (n=14). In miscarriage with a normal embryo, the population of Ki67(-)Foxp3(+)CD4(+) T cells was significantly smaller than in normal pregnancy. However, the frequencies of Ki67(+)Foxp3(+)CD4(+) cells and CCR5(+)Foxp3(+)CD4(+) cells were not different between the three groups. These data suggest that increased Ki67(-) Treg cells in the decidua basalis may play an important role in the induction of immune tolerance, and that immune-medicated pregnancy loss may be caused by decreased Ki67(-) Treg cells in the implantation site.

Local immune regulatory effects of Bangdeyun on the endometrium of mice with embryo implantation dysfunction during the implantation time.

This study examined the effects of Bangdeyun on the expressions of nuclear factor-kappaB (NF-kappaB), interferon-gamma (IFN-gamma) and interleukin-10 (IL-10) in the endometrium of mice with embryo implantation dysfunction (EID) during the implantation time (namely on pregnancy day 5, 6, 7 and 8) and explored the local immune regulatory effects of Bangdeyun. The gestational mice were randomly divided into normal group, model group and Bangdeyun-treated group. EID models of mice were established by using indomethacin. The endometrial expression of NF-kappaB was detected by immunohistochemistry and Western blotting. IFN-gamma and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA). The results showed that in the normal group, NF-kappaB and IFN-gamma were weakly expressed and IL-10 was strongly expressed in the endometrium during the whole implantation period. In the model group, the expressions of NF-kappaB and IFN-gamma were increased on pregnancy day 5, 6 and 7, and IL-10 expression decreased during the whole implantation time when compared with those in the normal group (P<0.01 for all). In the Bangdeyun-treated group, little amount of NF-kappaB and IFN-gamma was expressed and IL-10 expression was strong, much the way they were expressed in the normal group (P>0.05). The expressions of NF-kappaB and IFN-gamma were much lower in the Bangdeyun-treated group than those in the model group on pregnancy day 5, 6 and 7 (P<0.01 for all), while the expression of IL-10 was much higher than in the model group during the whole implantation time (P<0.01). It was suggested Bangderun may favor a shift from Th1- to Th2-type immune response, therefore inhibiting the maternal immune rejection, inducing the immune tolerance and improving the fetal implantation.

Comparison of the ontogeny of specific cell surface determinants on normal and delayed implanting mouse embryos.

The ontogeny of immunospecific cell surface determinants on preimplantation mouse embryos was determined by means of an antibody-dependent complement-mediated cell lysis assay. The determinants conferring sensitivity to lysis in that assay were first observed at the late blastocyst stage on embryos recovered from normal pregnancy on day 5 or grown to an equivalent stage in vitro. Although blastocysts recovered during the dormant phase associated with delayed implantation were not lysed, those recovered following reactivation with an injection of oestrogen to the mother were sensitive. Furthermore, it was found that treating the dormant embryos with neuraminidase rendered them sensitive to lysis. These results demonstrate that the appearance of specific cell surface determinants on mouse embryos is temporally associated with the process of attachment to the uterus in both normal pregnancy and at termination of the dormant phase associated with delayed implantation. They also indicate that those determinants may be 'masked' with sialic acid during embryonic diapause. It is suggested that such cell surface determinants could be important for embryo attachment and that the mechanism responsible for their expression may explain some aspects of the synchronization between the preimplantation conceptus and its mother at the time of implantation.

Changes in surface antigens on preimplantation mouse embryos.

Changes in the expression of specific cell surface antigens on preimplantation mouse embryos were examined by immunocytochemistry. Embryos were recovered at various times during the preimplantation phase of normal pregnancy, and from pregnancies with experimentally induced delayed implantation, and were probed with a panel of monoclonal antibodies against murine leukocyte antigens. Antibodies directed against certain macrophage surface glycoproteins (i.e., Mac-2 and Mac-3) and those against lysosome-associated membrane glycoproteins (i.e., LAMP-1 and LAMP-2) reacted specifically with cell surface determinants on the embryos. Differences in the spatiotemporal patterns of antibody binding during normal and delayed implantation indicate that expression of the antigenic determinants recognized by these antibodies is regulated individually in response to intrinsic as well as extrinsic signals at the time of implantation, and thus they may be important for the process of embryo implantation.