Spontan abortus ve istemli gebelik tahliyesi olgularında desiduada T lenfosit subgrupları ve uterin doğal öldürücü hücre sayılarının immunohistokimyasal yöntem ile karşılaştırılması

Semir Köse; Serap Karaarslan Takmaz; Murat Ulukuş; Osman Zekioğlu; Hüseyin Yılmaz

doi:10.19161/etd.551214

EN TR

An immunohistochemical staining study for comparison of the T lymphocyte subgroups and the uterine natural killer cells in the decidua from spontaneous abortions and voluntary pregnancy terminations

Abstract

Aim: To investigate the role of the decidual total T lymphocyte count, T cytotoxic (Tc) and T helper (Th) sub-populations and the uterin natural killer (uNK) cells in the pathogenesis of the spontaneous abortions (SA) and recurrent pregnancy loss (RPL) cases.

Materials and Methods: We included the SA (n:29) and the voluntary pregnancy termination (n:10) cases which were undergone suction curettage between January 2003-January 2005 at the Ege University Obstetrics and Gynecology Department and their paraffin blocks were obtained.

Results: Median CD3+ T lymphocyte cell counts were not different between the control (314; 210-489), incomplete abortions (560;183-1602) and missed abortions (426;154-1102) groups (p:0.117). Median CD4+ Th cell counts were not different between the control (143; 87-203), incomplete abortions (236;77-735) and missed abortions (236;76-677) groups (p:0.441). Median CD8+ Ts cell counts were not different between the control (179; 105-279), incomplete abortions (239;90-820) and missed abortions (197;84-560) groups (p:0.530). Median CD56+ uNK cell counts were not different between the control (634; 554-1390), incomplete abortions (714;653-2165) and missed abortions (712;306-2108) groups (p:0.099).

Conclusion: Abortions and RPL are heterogeneous groups consisting of cases representing various pathogenetic origins. Aberrant immune mechanisms could be responsible for a subgroup if not in all cases. Further studies designed by classifying the cases karyotypically and utilizing more sophisticated methods (such as flow cytometry, gene expression and receptor activation analyses) are needed to elucidate the complicated role of the immune system elements in the spontaneous abortion cases.

Keywords

Abortion,decidua,recurrent pregnancy loss,T lymphocytes,uterine natural killer cells.

Spontan abortus ve istemli gebelik tahliyesi olgularında desiduada T lenfosit subgrupları ve uterin doğal öldürücü hücre sayılarının immunohistokimyasal yöntem ile karşılaştırılması

Öz

Amaç: Desiduada T lenfositlerin toplam sayılarının, sitotoksik (Ts) ve helper (Th) alt gruplarının ve uterin naturel killer (uNK) hücre sayılarının abortuslar ve tekrarlayan gebelik kayıplarının (TGK) patogenezindeki rolünün araştırılması hedeflenmiştir.
Gereç ve Yöntem: Ocak 2003- Ocak 2005 tarihleri arasında Ege Üniversitesi Kadın Hastalıkları ve Doğum kliniğinde gebelik tahliyesi yapılmış ve küretaj materyallerine ait parafin blokları elde edilen abortus (n:29) ve sağlıklı kontrol olarak isteğe bağlı gebelik tahliyeleri (n:10) olguları çalışmaya dahil edildi. Tüm T lenfositler için ortak belirteç CD3, Th için CD4, Ts için CD8 ve uNK hücreleri için CD56 belirteçleri ile seçici immunohistokimyasal boyama sağlandı ve her preparat için 10 alanda hücreler sayıldı.

Bulgular: Medyan CD3+ T lenfosit toplam hücre sayıları kontrol grubunda 314 (210-489), inkomplet abortus grubunda 560 (183-1602) ve missed abortus grubunda ise 426 (154-1102) idi (p: 0.117). Medyan CD4+ Th hücre sayıları kontrol grubunda 143 (87-203), inkomplet abortus grubunda 236 (77-735) ve missed abortus grubunda ise 236 (76-677) idi (p: 0.441). Medyan CD8+ Ts hücre sayıları kontrol grubunda 179 (105-279), inkomplet abortus grubunda 239 (90-820) ve missed abortus grubunda 197 (84-560) idi (p:0.530). Medyan CD56+ uNK hücre sayıları kontrol grubunda 634 (554-1390), inkomplet abortus grubunda 714 (653-2165) ve missed abortus grubunda 712 (306-2108) idi (p:0.099).

Sonuç: Abortuslar ve TGK heterojen gruplardır ve farklı patogeneze sahip olgulardan oluşmaktadır. Bir alt grupta immün mekanizmalar nedensel rol oynuyor olabilir. Öncelikle karyotip analizi ile kategorize edilmiş gruplarda daha güncel metodlarla (akış sitometri, gen ekspresyon ve reseptör aktivasyon analizleri) yapılacak ileri çalışmalar abortuslarda immün sistem elemanlarının karmaşık rolünün aydınlatılması için gerekli görünmektedir.

Anahtar Kelimeler

Abortus,desidua,tekrarlayan gebelik kayıpları,T lenfositler,uterin doğal öldürücü hücreler.

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Semir Köse ^*
0000-0001-7621-7503
Türkiye

Serap Karaarslan Takmaz
0000-0002-3185-0505
Türkiye

Murat Ulukuş
0000-0002-1728-4797
Türkiye

Osman Zekioğlu
0000-0001-9728-4385
Türkiye

Hüseyin Yılmaz
0000-0002-7513-7285
Türkiye

Yayımlanma Tarihi

28 Haziran 2019

Gönderilme Tarihi

15 Eylül 2018

Kabul Tarihi

21 Kasım 2018

Yayımlandığı Sayı

Yıl 2019 Cilt: 58 Sayı: 2

DOI

https://doi.org/10.19161/etd.551214

IZ

https://izlik.org/JA82NT53NM

Kaynak Göster

RIS / Bibtex

Vancouver

1.Semir Köse, Serap Karaarslan Takmaz, Murat Ulukuş, Osman Zekioğlu, Hüseyin Yılmaz. Spontan abortus ve istemli gebelik tahliyesi olgularında desiduada T lenfosit subgrupları ve uterin doğal öldürücü hücre sayılarının immunohistokimyasal yöntem ile karşılaştırılması. ETD. 01 Haziran 2019;58(2):170-7. doi:10.19161/etd.551214