Human Reproduction, Vol 12, 1313-1320, Copyright © 1997 by Oxford University Press
RG Lea, M Tulppala and HO Critchley
Pregnancy failure in mice has been associated with increased placental
concentrations of the pro-inflammatory cytokine tumour necrosis factor-
alpha (TNF-alpha). To investigate the role of uterine TNF-alpha in human
first trimester miscarriage, we have collected human decidual and
trophoblast tissue from women (i) undergoing surgical termination of
pregnancy (n = 27), (ii) undergoing a sporadic miscarriage (n = 20) and
(iii) with a history of recurrent pregnancy loss [>3 consecutive
pregnancy losses (n = 26)] undergoing a further miscarriage. Formalin fixed
tissues were examined for TNF-alpha mRNA (in-situ hybridization) and
protein (immunohistochemistry). In decidua from all three groups, TNF-alpha
protein and mRNA were co-localized to the decidual stroma, the luminal
surface of some maternal vessels and to the glandular epithelium. Chorionic
villi from the normal pregnancy and the sporadic miscarriage group
exhibited co-localized TNF-alpha protein and mRNA in the
syncytiotrophoblast and cytotrophoblast. In the recurrent miscarriage
group, however, 63.6% of the biopsies showed positive immunostaining in
only the cytotrophoblast, compared with 4.0% of women undergoing surgical
termination of pregnancy and 0.0% of women with a sporadic failed pregnancy
(P < 0.001). TNF-alpha mRNA was also localized exclusively to this
layer. This may be a secondary effect caused by a different mechanism of
pregnancy loss unique to this subgroup.
ARTICLES
Deficient syncytiotrophoblast tumour necrosis factor-alpha characterizes failing first trimester pregnancies in a subgroup of recurrent miscarriage patients
Department of Obstetrics and Gynaecology, Centre for Reproductive Biology, University of Edinburgh, UK.
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