P.P. Jokhi

Functions of Human Decidual NK Cells

The main population of lymphocytes found in the human decidua during early pregnancy are NK‐like cells with a distinctive phenotype, CD56bright CD16− CD3−. These cells are in close association with invading trophoblast that may be their in vivo target. We have examined three aspects of decidual NK function in vitro: cytotoxicity, proliferation, and cytokine production. The functional assays indicate uterine lymphocytes differ fundamentally from both PBL and even from classical circulating NK cells. Their role in the establishment of normal pregnancy remains unknown.

Reciprocal expression of epidermal growth factor receptor (EGF-R) and c-erbB2 by non-invasive and invasive human trophoblast populations

Trophoblast invasion of the maternal uterus during human placentation is a highly complex process involving proliferation, migration and cell differentiation. Tyrosine kinase receptors are known to be involved in such functions. The epidermal growth factor-receptor (EGF-R) and c-erbB2 proto-oncogene products are two closely related tyrosine kinase receptors which are expressed in high amounts in human placenta. In this study, we have investigated the expression of EGF-R and c-erbB2 proteins by different trophoblast populations using immunohistochemistry. EGF-R was expressed by proliferative villous cytotrophoblasts, but not by non-proliferative, invasive, extravillous cytotrophoblasts. In contrast, c-erbB2 was expressed by invasive extravillous trophoblasts (EVT) but not by villous cytotrophoblasts. Expression of both receptors was seen only by the terminally differentiated placental bed giant cell and villous syncytiotrophoblast populations. This precise spatial expression suggests that EGF-R plays an important role in trophoblast proliferation whereas c-erbB2 may be important for trophoblast invasion and differentiation. The surface expression of these receptors on normal isolated first trimester trophoblasts and on choriocarcinoma cell lines was also investigated by flow cytometry, and compared with that of the c-erbB2-overexpressing mammary tumour cell line BT474. Isolated trophoblasts were shown not to overexpress c-erbB2, and no differences in either EGF-R or c-erbB2 expression were seen between normal and malignant trophoblasts.

Demonstration of the low affinity α subunit of the granulocyte-macrophage colony-stimulating factor receptor (GM-CSF-Rα) on human trophoblast and uterine cells

Abstract Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a classical haematopoietic cytokine which has also been implicated in placental growth and development. In this study we have performed a detailed immunohistological localization of the low affinity GM-CSF receptor (GM-CSF-Rα) in human first trimester implantation site and non-pregnant endometrium. We have also investigated receptor expression and GM-CSF binding in vitro by normal first trimester trophoblast using flow cytometric analysis and compared this with JEG-3 and JAR choriocarcinoma cells. In the first trimester, the GM-CSF-R was found to be present on villous cytotrophoblast and all populations of extravillous trophoblast. Expression by villous syncytiotrophoblast was weak or absent, but this increased markedly by term. GM-CSF-R were also expressed by fetal Hofbauer cells within the mesenchyme of the chorionic villi and by uterine glandular epithelium and decidual macrophages within maternal decidua. GM-CSF-R was not expressed by glands in proliferative phase endometrium but began to appear during the secretory phase, suggesting hormonal regulation of the receptor on uterine glandular epithelium. Flow cytometric comparison of normal isolated first trimester trophoblast and JEG-3 and JAR choriocarcinoma cells revealed two- to threefold higher surface expression of GM-CSF-R by choriocarcinoma cells and higher binding capacity for rhGM-CSF than normal trophoblast. These results suggest that GM-CSF may regulate growth and development of human trophoblast. GM-CSF may also influence placental development and function by acting via decidual and fetal macrophages, and uterine glandular epithelium, which are the other cell populations to express the receptor.

Expression of c-kit and kit ligand at the human maternofetal interface.

Kit ligand, or stem cell factor, is a recently identified growth factor, which binds to and activates the c-kit proto-oncogene, and which has been shown to act synergistically with other haematopoietic growth factors in the bone marrow. We have previously shown that several isoforms of kit ligand, which arise due to alternative splicing, are expressed in human placenta. In order to elucidate the role of c-kit and its ligand during human placental development we have investigated the expression of c-kit and kit ligand in human first trimester and term placenta as well as in pregnant and non-pregnant endometrium, by immunocytochemistry and flow cytometric analysis. In non-pregnant endometrium no expression of kit ligand was seen. By contrast, in first trimester decidua, kit ligand was strongly expressed by the arterial media of maternal blood vessels. Kit ligand was also expressed throughout pregnancy by invasive fetal extravillous trophoblast, and by fetal fibroblasts within the placental villi. c-kit was found to be expressed on Hofbauer cells within the chorionic villi, and by decidual macrophages at all stages in pregnancy. c-kit was also detected on the small CD56dim subset of uterine large granular lymphocytes which form the major leukocyte population in human first trimester decidua. Our results suggest that kit ligand may be involved in the regulation of fetal macrophages, and in particular in signalling between invading extravillous trophoblast which expresses kit ligand, and maternal leukocytes bearing the c-kit receptor.

Role of Decidual Large Granular Lymphocytes/Natural Killer Cells in Human Implantation

Human placental implantation involves invasion of the uterus by placental trophoblast cells. The extent of this invasion is tightly controlled. Insufficient invasion will lead to inadequate blood supply to the fetoplacental unit, and overextensive invasion will result in placenta percreta (1). The mechanisms that control this trophoblast invasion are not known. The decidua is likely to provide an important element of this control because implantation over areas deficient in decidua, such as over a previous cesarean section scar or in the fallopian tubes, generally shows a significantly greater degree of trophoblast invasion. It is unclear, however, which component of the decidua is important in this regard.