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Søndergaard SH, Kamper-Jørgensen M. Pregnancy, cardiovascular health, and microchimerism. Curr Opin Lipidol 2024; 35:7-13. [PMID: 37982290 DOI: 10.1097/mol.0000000000000914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
PURPOSE OF REVIEW To provide an updated review of scientific literature concerning associations between pregnancy and cardiovascular health among women, and to discuss a possible impact of microchimerism on the association. RECENT FINDINGS In most studies, pregnancy and childbirth is associated with increased risk of cardiovascular disease in women. Some ascribe the association mainly to lifestyle, whereas others suggest that pregnancy itself negatively affects women's cardiovascular health. Pregnancy is a natural source of microchimerism, which in turn markedly affects female health. The only study published in the area surprisingly shows that among middle-aged women, male-origin microchimerism (MOM) is associated with half the risk of developing ischemic heart disease (IHD). No similar association is found between MOM and ischemic stroke. SUMMARY The sparse evidence published suggests reduced risk of developing IHD among MOM-positive women. Despite the association being biologically plausible, replication of the findings is warranted to support that this is not a chance finding.
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Affiliation(s)
- Sara Hallum Søndergaard
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen K, Denmark
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2
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Ribeiro RSDA, Demarque KC, Figueiredo Júnior I, Ferreira IMDESR, Valeriano JDP, Verícimo MA. Do Fetal Microchimeric Cells Influence Experimental Autoimmune Myocarditis? Fetal Pediatr Pathol 2022; 41:781-793. [PMID: 34678109 DOI: 10.1080/15513815.2021.1994067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: We investigated the presence and influence of fetal microchimerism in the cardiac tissue of mated female mice submitted to experimental autoimmune myocarditis. Materials and methods: Nulliparous BALB/c females and BALB/c females mated with either BALB/c males (syngeneic mating) or C57BL/6 males (allogeneic mating) were immunized with cardiac myosin peptide MyHC-α614-629 or kept as non-immunized controls. Immunization occurred 6-8 weeks after delivery and mice were assessed after 21 days. Results: Immunized mice of allogeneic mating had a lower production of anti-MyHC-α614-629 antibodies compared to immunized nulliparous mice. Immunized nulliparous females had an intense mononuclear inflammatory infiltrate in cardiac tissue, associated with fibroplasia, while mated females had a lower inflammatory reaction. An increase in the frequency of microchimeric fetal cells was observed in mice submitted to allogeneic mating following immunization. Conclusion: Allogeneic cells of fetal origin could contribute to mitigating the inflammatory response in experimental myocarditis.
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Affiliation(s)
- Roberto Stefan de Almeida Ribeiro
- Department of Immunobiology, Institute of Biology, Federal Fluminense University, Niterói, Brazil.,Graduate Program in Pathology, Federal Fluminense University, Niterói, Brazil
| | | | - Israel Figueiredo Júnior
- Maternal and Child Department, Antônio Pedro University Hospital, Federal Fluminense University, Niterói, Brazil
| | | | - Jessica do Prado Valeriano
- Department of Immunobiology, Institute of Biology, Federal Fluminense University, Niterói, Brazil.,Graduate Program in Pathology, Federal Fluminense University, Niterói, Brazil
| | - Maurício Afonso Verícimo
- Department of Immunobiology, Institute of Biology, Federal Fluminense University, Niterói, Brazil.,Graduate Program in Pathology, Federal Fluminense University, Niterói, Brazil
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3
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Wysocki T, Olesińska M, Paradowska-Gorycka A. Current Understanding of an Emerging Role of HLA-DRB1 Gene in Rheumatoid Arthritis-From Research to Clinical Practice. Cells 2020; 9:cells9051127. [PMID: 32370106 PMCID: PMC7291248 DOI: 10.3390/cells9051127] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 12/22/2022] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease with an unclear pathogenic mechanism. However, it has been proven that the key underlying risk factor is a genetic predisposition. Association studies of the HLA-DRB1 gene clearly indicate its importance in RA morbidity. This review presents the current state of knowledge on the impact of HLA-DRB1 gene, functioning both as a component of the patient’s genome and as an environmental risk factor. The impact of known HLA-DRB1 risk variants on the specific structure of the polymorphic HLA-DR molecule, and epitope binding affinity, is presented. The issues of the potential influence of HLA-DRB1 on the occurrence of non-articular disease manifestations and response to treatment are also discussed. A deeper understanding of the role of the HLA-DRB1 gene is essential to explore the complex nature of RA, which is a result of multiple contributing factors, including genetic, epigenetic and environmental factors. It also creates new opportunities to develop modern and personalized forms of therapy.
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Affiliation(s)
- Tomasz Wysocki
- Department of Systemic Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637 Warsaw, Poland; or
- Correspondence:
| | - Marzena Olesińska
- Department of Systemic Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637 Warsaw, Poland; or
| | - Agnieszka Paradowska-Gorycka
- Department of Molecular Biology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637 Warsaw, Poland; or
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4
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Johnson BN, Ehli EA, Davies GE, Boomsma DI. Chimerism in health and potential implications on behavior: A systematic review. Am J Med Genet A 2020; 182:1513-1529. [PMID: 32212323 DOI: 10.1002/ajmg.a.61565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 02/03/2020] [Accepted: 03/02/2020] [Indexed: 12/12/2022]
Abstract
In this review, we focus on the phenomenon of chimerism and especially microchimerism as one of the currently underexplored explanations for differences in health and behavior. Chimerism is an amalgamation of cells from two or more unique zygotes within a single organism, with microchimerism defined by a minor cell population of <1%. This article first presents an overview of the primary techniques employed to detect and quantify the presence of microchimerism and then reviews empirical studies of chimerism in mammals including primates and humans. In women, male microchimerism, a condition suggested to be the result of fetomaternal exchange in utero, is relatively easily detected by polymerase chain reaction molecular techniques targeting Y-chromosomal markers. Consequently, studies of chimerism in human diseases have largely focused on diseases with a predilection for females including autoimmune diseases, and female cancers. We detail studies of chimerism in human diseases and also discuss some potential implications in behavior. Understanding the prevalence of chimerism and the associated health outcomes will provide invaluable knowledge of human biology and guide novel approaches for treating diseases.
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Affiliation(s)
- Brandon N Johnson
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota, USA
| | - Erik A Ehli
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota, USA
| | - Gareth E Davies
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota, USA
| | - Dorret I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
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5
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Jafarinia M, Amoon M, Javid A, Vakili S, Sadeghi E, Azadi D, Alsahebfosoul F. Male microchimerism in peripheral blood from women with multiple sclerosis in Isfahan Province. Int J Immunogenet 2019; 47:175-179. [PMID: 31833227 DOI: 10.1111/iji.12465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/24/2019] [Accepted: 11/27/2019] [Indexed: 12/20/2022]
Abstract
Multiple sclerosis (MS) is referred to as an organ-specific T-cell-mediated autoimmune disease of the central nervous system (CNS). Different genetic and environmental factors increase the risk of developing MS. In recent years, microchimerism (Mc) has been widely studied in autoimmune diseases, although the exact role of this phenomenon in human health is not known well. Microchimerism is the low level presence of DNA or cells from one individual into the tissue or circulation of another individual. In the current study, we evaluated the association of fetal microchimerism (FMc) with MS in Isfahan province. In this study, we enrolled 68 women in four groups. Two groups were MS patients with or without a pregnancy for a son, and the other two groups were MS-negative patients with or without a pregnancy for a son. The presence of the male genome assessed and compared in these groups. Four millilitres of peripheral blood were collected from all subjects in the tube containing EDTA and DNA was extracted. Real-time PCR assay was used for the DAZ (deleted in azoospermia) region Yq 11.23 as a marker for male microchimerism in all subjects. Our results showed that the percentage of DAZ (male genome)-positive women was significantly higher in MS-positive women given birth to a son in comparison with the other three groups. Our results also revealed no significant correlation between the percentage of DAZ-positive women and Expanded Disability Status Scale (EDSS) score and age of onset in the patients' group. For future studies, we suggest enrolling subjects who MS diagnosis occurred before and after pregnancy with a son. Comparing FMc in these two groups might provide a better understanding of the possible role of FMc in later development of MS.
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Affiliation(s)
- Morteza Jafarinia
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mina Amoon
- Department of Biology, Faculty of Science and Engineering, Science and Arts University, Yazd, Iran
| | - Ameneh Javid
- Department of Biology, Faculty of Science and Engineering, Science and Arts University, Yazd, Iran
| | - Sina Vakili
- Biochemistry Department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Erfan Sadeghi
- Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.,Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Davood Azadi
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran.,Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
| | - Fereshteh Alsahebfosoul
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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6
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Cruz GI, Shao X, Quach H, Ho KA, Sterba K, Noble JA, Patsopoulos NA, Busch MP, Triulzi DJ, Wong WSW, Solomon BD, Niederhuber JE, Criswell LA, Barcellos LF. A Child's HLA-DRB1 genotype increases maternal risk of systemic lupus erythematosus. J Autoimmun 2016; 74:201-207. [PMID: 27388144 DOI: 10.1016/j.jaut.2016.06.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/23/2016] [Accepted: 06/27/2016] [Indexed: 11/17/2022]
Abstract
Systemic lupus erythematosus (SLE) disproportionately affects women of reproductive age. During pregnancy, women are exposed to various sources of fetal material possibly constituting a significant immunologic exposure relevant to the development of SLE. The objective of this study was to investigate whether having any children who carry DRB1 alleles associated with SLE increase the risk of maternal SLE. This case-control study is based on the University of California, San Francisco Mother-Child Immunogenetic Study and from studies at the Inova Translational Medicine Institute. Analyses were conducted using data for 1304 mothers (219 cases/1085 controls) and their respective 1664 children. We selected alleles based on their known association with risk of SLE (DRB1*03:01, *15:01, or *08:01) or Epstein-Barr virus (EBV) glycoproteins (*04:01) due to the established EBV association with SLE risk. We used logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI) for each allele of interest, taking into account maternal genotype and number of live births. We found an increase in risk of maternal SLE associated with exposure to children who inherited DRB1*04:01 from their father (OR 1.9; 95% CI, 1.1-3.2), among *04:01 allele-negative mothers. Increased risk was only present among mothers who were positive for one or more SLE risk-associated alleles (*03:01, *15:01 and/or *08:01). We did not find increased risk of maternal SLE associated with any other tested allele. These findings support the hypothesis that a child's alleles inherited from the father influence a mother's subsequent risk of SLE.
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Affiliation(s)
- Giovanna I Cruz
- Genetic Epidemiology and Genomics Lab, Division of Epidemiology, School of Public Health, University of California Berkeley, 324 Stanley Hall, Berkeley, CA 94720-3220, USA.
| | - Xiaorong Shao
- Genetic Epidemiology and Genomics Lab, Division of Epidemiology, School of Public Health, University of California Berkeley, 324 Stanley Hall, Berkeley, CA 94720-3220, USA.
| | - Hong Quach
- Genetic Epidemiology and Genomics Lab, Division of Epidemiology, School of Public Health, University of California Berkeley, 324 Stanley Hall, Berkeley, CA 94720-3220, USA.
| | - Kimberly A Ho
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, San Francisco, CA 94122, USA.
| | - Kirsten Sterba
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, San Francisco, CA 94122, USA.
| | - Janelle A Noble
- Children's Hospital Oakland Research Institute, 5700 M.L.K. Jr. Way, Oakland, CA 94609, USA.
| | - Nikolaos A Patsopoulos
- Division of Genetics, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115, USA; Program in Translational Neuropsychiatric Genomics, Institute for the Neurosciences, Department of Neurology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, 415 Main Street, Cambridge, MA 02142, USA.
| | - Michael P Busch
- Blood Systems Research Institute, 270 Masonic Avenue, San Francisco, CA 94118-4417, USA.
| | - Darrell J Triulzi
- Institute for Transfusion Medicine, Department of Pathology, University of Pittsburgh, 3636 Blvd. of the Allies, Pittsburgh, PA 15213, USA.
| | - Wendy S W Wong
- Division of Medical Genomics, Inova Translational Medicine Institute, 8110 Gatehouse Road, Falls Church, VA 22042, USA.
| | - Benjamin D Solomon
- Division of Medical Genomics, Inova Translational Medicine Institute, 8110 Gatehouse Road, Falls Church, VA 22042, USA.
| | - John E Niederhuber
- Division of Medical Genomics, Inova Translational Medicine Institute, 8110 Gatehouse Road, Falls Church, VA 22042, USA.
| | - Lindsey A Criswell
- Rosalind Russell/Ephraim P. Engleman Rheumatology Research Center, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, San Francisco, CA 94122, USA.
| | - Lisa F Barcellos
- Genetic Epidemiology and Genomics Lab, Division of Epidemiology, School of Public Health, University of California Berkeley, 324 Stanley Hall, Berkeley, CA 94720-3220, USA; California Institute for Quantitative Biosciences (QB3), University of California Berkeley, 174 Stanley Hall, Berkeley, CA 94720-3220, USA.
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7
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Abstract
During pregnancy maternal and fetal cells commute back and forth leading to fetal microchimerism in the mother and maternal microchimerism in the child that can persist for years after the birth. Chimeric fetal and maternal cells can be hematopoietic or can differentiate into somatic cells in multiple organs, potentially acting as targets for ‘autoimmunity' and so have been implicated in the pathogenesis of autoimmune diseases that resemble graft-versus-host disease after stem cell transplantation. Fetal cells have been found in women with systemic lupus erythematosus, both in the blood and a target organ, the kidney, suggesting that they may be involved in pathogenesis. Future studies will address how the host immune system normally tolerates maternal and fetal cells or how the balance may change during autoimmunity.
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Affiliation(s)
- A M Stevens
- Department of Pediatrics, University of Washington, Childrens Hospital and Regional Medical Center, 307 Westlake Ave N, Suite 300, Seattle, WA 98109, Washington, USA.
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8
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Artlett CM, Sassi-Gaha S, Ramos RC, Miller FW, Rider LG. Chimeric cells of maternal origin do not appear to be pathogenic in the juvenile idiopathic inflammatory myopathies or muscular dystrophy. Arthritis Res Ther 2015; 17:238. [PMID: 26338728 PMCID: PMC4558637 DOI: 10.1186/s13075-015-0732-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 07/28/2015] [Indexed: 01/08/2023] Open
Abstract
Introduction Microchimeric cells have been studied for over a decade, with conflicting reports on their presence and role in autoimmune and other inflammatory diseases. To determine whether microchimeric cells were pathogenic or mediating tissue repair in inflammatory myopathies, we phenotyped and quantified microchimeric cells in juvenile idiopathic inflammatory myopathies (JIIM), muscular dystrophy (MD), and noninflammatory control muscle tissues. Method Fluorescence immunophenotyping for infiltrating cells with sequential fluorescence in situ hybridization was performed on muscle biopsies from ten patients with JIIM, nine with MD and ten controls. Results Microchimeric cells were significantly increased in MD muscle (0.079 ± 0.024 microchimeric cells/mm2 tissue) compared to controls (0.019 ± 0.007 cells/mm2 tissue, p = 0.01), but not elevated in JIIM muscle (0.043 ± 0.015 cells/mm2). Significantly more CD4+ and CD8+ microchimeric cells were in the muscle of patients with MD compared with controls (mean 0.053 ± 0.020/mm2 versus 0 ± 0/mm2p = 0.003 and 0.043 ± 0.023/mm2 versus 0 ± 0/mm2p = 0.025, respectively). No differences in microchimeric cells between JIIM, MD, and noninflammatory controls were found for CD3+, Class II+, CD25+, CD45RA+, and CD123+ phenotypes, and no microchimeric cells were detected in CD20, CD83, or CD45RO populations. The locations of microchimeric cells were similar in all three conditions, with MD muscle having more microchimeric cells in perimysial regions than controls, and JIIM having fewer microchimeric muscle nuclei than MD. Microchimeric inflammatory cells were found, in most cases, at significantly lower proportions than autologous cells of the same phenotype. Conclusions Microchimeric cells are not specific to autoimmune disease, and may not be important in muscle inflammation or tissue repair in JIIM.
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Affiliation(s)
- Carol M Artlett
- Department of Microbiology and Immunology, Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, PA, 19129, USA.
| | - Sihem Sassi-Gaha
- Department of Microbiology and Immunology, Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, PA, 19129, USA.
| | - Ronald C Ramos
- Department of Medicine, Thomas Jefferson University, 1020 Walnut Street, Philadelphia, PA, 19107, USA. .,Present address: Agis Global, Business Development Executive, 1266 East Main Street, Stamford, CT, 06902, USA.
| | - Frederick W Miller
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Environmental Autoimmunity Group, Program of Clinical Research, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
| | - Lisa G Rider
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Environmental Autoimmunity Group, Program of Clinical Research, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
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Boddy AM, Fortunato A, Wilson Sayres M, Aktipis A. Fetal microchimerism and maternal health: a review and evolutionary analysis of cooperation and conflict beyond the womb. Bioessays 2015; 37:1106-18. [PMID: 26316378 PMCID: PMC4712643 DOI: 10.1002/bies.201500059] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The presence of fetal cells has been associated with both positive and negative effects on maternal health. These paradoxical effects may be due to the fact that maternal and offspring fitness interests are aligned in certain domains and conflicting in others, which may have led to the evolution of fetal microchimeric phenotypes that can manipulate maternal tissues. We use cooperation and conflict theory to generate testable predictions about domains in which fetal microchimerism may enhance maternal health and those in which it may be detrimental. This framework suggests that fetal cells may function both to contribute to maternal somatic maintenance (e.g. wound healing) and to manipulate maternal physiology to enhance resource transmission to offspring (e.g. enhancing milk production). In this review, we use an evolutionary framework to make testable predictions about the role of fetal microchimerism in lactation, thyroid function, autoimmune disease, cancer and maternal emotional, and psychological health. Also watch the Video Abstract.
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Affiliation(s)
- Amy M Boddy
- Department of Psychology, Arizona State University, Tempe, AZ, USA.,Center for Evolution and Cancer, University of California San Francisco, San Francisco, CA, USA
| | - Angelo Fortunato
- Center for Evolution and Cancer, University of California San Francisco, San Francisco, CA, USA
| | - Melissa Wilson Sayres
- Center for Evolution and Medicine, The Biodesign Institute, Arizona State University, Tempe, AZ, USA.,School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Athena Aktipis
- Department of Psychology, Arizona State University, Tempe, AZ, USA.,Center for Evolution and Cancer, University of California San Francisco, San Francisco, CA, USA.,Center for Evolution and Medicine, The Biodesign Institute, Arizona State University, Tempe, AZ, USA
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10
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Cirello V, Rizzo R, Crippa M, Campi I, Bortolotti D, Bolzani S, Colombo C, Vannucchi G, Maffini MA, de Liso F, Ferrero S, Finelli P, Fugazzola L. Fetal cell microchimerism: a protective role in autoimmune thyroid diseases. Eur J Endocrinol 2015; 173:111-8. [PMID: 25916393 DOI: 10.1530/eje-15-0028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/27/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The physiological persistence of fetal cells in the circulation and tissue of a previously pregnant woman is called fetal cell microchimerism (FCM). It has been hypothesized to play a role in systemic autoimmune disease; however, only limited data are available regarding its role in autoimmune thyroid disease (AITD). DESIGN Circulating FCM was analyzed in a large series of previously pregnant women with Graves' disease (GD), Hashimoto's thyroiditis (HT), or no disease (healthy controls (HCs)). To exclude the possible bias related to placental factors, the polymorphic pattern of human leukocyte antigen-G (HLA-G) gene, which is known to be involved in the tolerance of fetal cells by the maternal immune system, was investigated. METHODS FCM was evaluated by PCR in the peripheral blood, and the Y chromosome was identified by fluorescence in situ hybridization in some GD tissues. HLA-G polymorphism typing was assessed by real-time PCR. RESULTS FCM was significantly more frequent in HC (63.6%) than in GD (33.3%) or HT (27.8%) women (P=0.0004 and P=0.001 respectively). A quantitative analysis confirmed that circulating male DNA was more abundant in HC than it was in GD or HT. Microchimeric cells were documented in vessels and in thyroid follicles. In neither GD/HT patients nor HC women was the HLA-G typing different between FCM-positive and FCM-negative cases. CONCLUSION The higher prevalence of FCM in HC as compared to GD and HT patients suggests that it plays a possible protective role in autoimmune thyroid disorders. Placental factors have been excluded as determinants of the differences found. The vascular and tissue localization of microchimeric cells further highlights the ability of those cells to migrate to damaged tissues.
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Affiliation(s)
- Valentina Cirello
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Roberta Rizzo
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Milena Crippa
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Irene Campi
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Daria Bortolotti
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Silvia Bolzani
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Carla Colombo
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Guia Vannucchi
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Maria Antonia Maffini
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Federica de Liso
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Stefano Ferrero
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Palma Finelli
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
| | - Laura Fugazzola
- Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy Endocrine UnitFondazione IRCCS Ca' Granda, Via F. Sforza, 35-20122 Milan, ItalyDepartment of Pathophysiology and TransplantationUniversity of Milan, Milan, ItalySection of Microbiology and Medical GeneticsDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyLaboratory of Medical Cytogenetics and Molecular GeneticsIstituto Auxologico Italiano, Milan, ItalyDepartment of Clinical Sciences and Community HealthUniversity of Milan, Milan, ItalyLaboratory of Clinical Chemistry and MicrobiologyFondazione IRCCS Ca' Granda, Milan, ItalyDivision of PathologyFondazione IRCCS Ca' Granda, Milan, ItalyDepartments of BiomedicalSurgical and Dental SciencesMedical Biotechnology and Translational MedicineUniversity of Milan, Milan, Italy
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Fetal microchimerism in kidney biopsies of lupus nephritis patients may be associated with a beneficial effect. Arthritis Res Ther 2015; 17:101. [PMID: 25889410 PMCID: PMC4416327 DOI: 10.1186/s13075-015-0615-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 04/01/2015] [Indexed: 12/03/2022] Open
Abstract
Introduction Microchimeric male fetal cells (MFCs) have been associated with systemic lupus erythematosus, and published studies have further correlated MFC with lupus nephritis (LN). In the present study, we evaluated the frequency of MFC in the renal tissue of patients with LN. Methods Twenty-seven renal biopsies were evaluated: Fourteen were from women with clinical and laboratory findings of LN, and thirteen were from controls. Genomic DNA was extracted from kidney biopsies, and the male fetal DNA was quantified using real-time quantitative polymerase chain reactions for the detection of specific Y chromosome sequences. Results MFCs were detected in 9 (64%) of 14 of patients with LN, whereas no MFCs were found in the control group (P = 0.0006). No differences in pregnancy history were found between patients with LN and the control group. Significantly higher amounts of MFCs were found in patients with LN with serum creatinine ≤1.5 mg/dl. Furthermore, women with MFCs had significantly better renal function at the time of biopsy (P = 0.03). In contrast, patients with LN without MFCs presented with more severe forms of glomerulonephritis (World Health Organization class IV = 60% and class V = 40%). Conclusions Our data indicate a high prevalence of MFCs in renal biopsy specimens from women with LN, suggesting a role for MFCs in the etiology of LN. The present report also provides some evidence that MFCs could have a beneficial effect in this disease. Electronic supplementary material The online version of this article (doi:10.1186/s13075-015-0615-4) contains supplementary material, which is available to authorized users.
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Kekow M, Barleben M, Drynda S, Jakubiczka S, Kekow J, Brune T. Long-term persistence and effects of fetal microchimerisms on disease onset and status in a cohort of women with rheumatoid arthritis and systemic lupus erythematosus. BMC Musculoskelet Disord 2013; 14:325. [PMID: 24245522 PMCID: PMC3835618 DOI: 10.1186/1471-2474-14-325] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 10/31/2013] [Indexed: 12/20/2022] Open
Abstract
Background The discovery of a fetal cells transfer to the mother is a phenomenon with multiple implications for autoimmunity and tolerance. The prevalence and meaning of the feto-maternal microchimerism (MC) in rheumatic diseases has not been thoroughly investigated. The aim of this study was to analyze the prevalence of fetal MC in patients with inflammatory rheumatic diseases and to investigate the association of MC with disease onset and current status. Methods A total of 142 women who gave birth to at least one male offspring were recruited: 72 women with rheumatoid arthritis (RA), 16 women with systemic lupus erythematosus (SLE), and 54 healthy women. For the detection of fetal microchimerism a nested PCR method was used to amplify a Y chromosome specific sequence (TSPY1). For characterization of disease activity we analyzed autoantibody profiles and X-rays in RA, and in addition complement levels in SLE respectively. Results A significant higher prevalence of fetal MC was found in RA (18%) and SLE (31%) compared to controls (3.7%) (p = 0.02 and p = 0.006, resp.). The mean age at disease onset was comparable in MC + and MC- RA patients. Disease onset occurred 18.7 (MC +) and 19.8 (MC-) years post partum of the first son, respectively. The presence of anti-CCP and RF did not differ significantly, anti-CCP were found in 75% of MC + and 87% of MC- patients, RF in 75% of both MC + and MC- patients. A slightly higher mean Steinbrocker score in MC + patients was associated with longer disease duration in MC + compared to MC- RA. In SLE patients the mean age at disease onset was 42.6 years in MC + and 49.1 years in MC- patients. Disease onset occurred 24.0 and 26.4 years post partum of the first son for MC + and MC- patients, respectively. The presence of ANA and anti-dsDNA antibodies, C3, C4 and CH50 did not differ significantly. Conclusion Our results indicate a higher frequency of long-term male MC in RA and SLE patients compared with controls without impact on disease onset and status in RA and SLE.
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Affiliation(s)
- Marianne Kekow
- Children's Hospital, University of Magdeburg, Leipziger Str, 44, Magdeburg 39120, Germany.
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Kanold AMJ, Svenungsson E, Gunnarsson I, Götherström C, Padyukov L, Papadogiannakis N, Uzunel M, Westgren M. A research study of the association between maternal microchimerism and systemic lupus erythematosus in adults: a comparison between patients and healthy controls based on single-nucleotide polymorphism using quantitative real-time PCR. PLoS One 2013; 8:e74534. [PMID: 24040274 PMCID: PMC3770650 DOI: 10.1371/journal.pone.0074534] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 08/05/2013] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Naturally acquired microchimerism may arise in the mother and her child during pregnancy when bidirectional trafficking of cells occurs through the placental barrier. The occurrence of maternal microchimerism (maternal cells in the offspring) has been associated with several autoimmune diseases, especially in children. Systemic Lupus erythematosus (SLE) is an autoimmune disorder with a resemblance to graft-versus-host disease. The aim of this study was to investigate the association between maternal microchimerism in the blood and SLE. METHODOLOGY/PRINCIPAL FINDINGS Thirty-two patients with SLE, 17 healthy brothers of the patients, and an additional 12 unrelated healthy men were the subjects in this study. A single-nucleotide polymorphism unique to each mother was identified, and maternal microchimerism in the study group and in the control group was detected using a quantitative real-time polymerase chain reaction technique. No differences in the frequency or the concentration of maternal cells were apparent in the blood of patients with SLE or in that of the controls. Two patients and one control tested positive for maternal microchimerism, but the positive subjects were all negative at a follow-up 16 years later. The sensitivity of the method was estimated to 1/10.000. CONCLUSIONS/SIGNIFICANCE These results show no association between SLE and maternal microchimerism. The frequency of maternal microchimerism in the blood of adults overall may be lower than earlier reported.
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Affiliation(s)
- Anna Maria Jonsson Kanold
- Department of Obstetrics and Gynecology, Center for Fetal Medicine, Karolinska University Hospital, Huddinge, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Elisabet Svenungsson
- Department of Medicine Solna, Rheumatology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Iva Gunnarsson
- Department of Medicine Solna, Rheumatology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Götherström
- Department of Obstetrics and Gynecology, Center for Fetal Medicine, Karolinska University Hospital, Huddinge, Karolinska Institutet, Stockholm, Sweden
- Division for Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Leonid Padyukov
- Department of Medicine Solna, Rheumatology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Nikos Papadogiannakis
- Department of Laboratory Medicine, Division of PathologySection of Perinatal Pathology, Karolinska University Hospital, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Mehmet Uzunel
- Division for Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Westgren
- Department of Obstetrics and Gynecology, Center for Fetal Medicine, Karolinska University Hospital, Huddinge, Karolinska Institutet, Stockholm, Sweden
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Lepez T, Vandewoestyne M, Deforce D. Fetal microchimeric cells in autoimmune thyroid diseases: harmful, beneficial or innocent for the thyroid gland? CHIMERISM 2013; 4:111-8. [PMID: 23723083 PMCID: PMC3921191 DOI: 10.4161/chim.25055] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Autoimmune thyroid diseases (AITD) show a female predominance, with an increased incidence in the years following parturition. Fetal microchimerism has been suggested to play a role in the pathogenesis of AITD. However, only the presence of fetal microchimeric cells in blood and in the thyroid gland of these patients has been proven, but not an actual active role in AITD. Is fetal microchimerism harmful for the thyroid gland by initiating a Graft versus Host reaction (GvHR) or being the target of a Host versus Graft reaction (HvGR)? Is fetal microchimerism beneficial for the thyroid gland by being a part of tissue repair or are fetal cells just innocent bystanders in the process of autoimmunity? This review explores every hypothesis concerning the role of fetal microchimerism in AITD.
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Abstract
Maternal-fetal cellular trafficking (MFCT) is the bidirectional passage of cells that results in the presence of fetal cells in the mother and maternal cells in the fetus. This naturally occurring biological phenomenon has been implicated in the pathogenesis of autoimmune diseases in both mothers and children. However, MFCT may also have beneficial consequences in establishing and maintaining maternal-fetal tolerance and may have long-term consequences for transplantation tolerance. There is also evidence that trafficking is altered during pregnancy complications and fetal intervention. An improved understanding of cellular trafficking during pregnancy will lead to progress in multiple fields including autoimmunity, transplantation, and fetal surgery.
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Affiliation(s)
- Amar Nijagal
- Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research and The Fetal Treatment Center, University of California, San Francisco, California 94143-0570, USA
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Y chromosome microchimerism in patients with systemic lupus erythematosus. EGYPTIAN RHEUMATOLOGIST 2012. [DOI: 10.1016/j.ejr.2011.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Greer LG, Casey BM, Halvorson LM, Spong CY, McIntire DD, Cunningham FG. Antithyroid antibodies and parity: further evidence for microchimerism in autoimmune thyroid disease. Am J Obstet Gynecol 2011; 205:471.e1-4. [PMID: 21944225 DOI: 10.1016/j.ajog.2011.06.060] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 03/25/2011] [Accepted: 06/16/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Fetal microchimerism may have a role in development of autoimmune thyroid disorders. Using parity as a surrogate for increasing fetal cell exposure, we analyzed its association with thyroid peroxidase antibody levels. STUDY DESIGN Secondary analysis of serum thyroid analytes determined in 17,298 women from a population-based prospective study between 2001 and 2003. Sera were assayed for thyrotropin, free thyroxine, and antithyroid peroxidase antibodies. We analyzed the relationship between thyroid peroxidase antibodies and increasing parity. RESULTS The incidence of abnormally elevated thyroid peroxidase antibody levels (>50 IU/mL) increased with advancing parity, but was not significant after adjustment for maternal characteristics. However, at higher thyroid peroxidase antibody levels (>500 IU/mL), a significant relationship with advancing parity persisted after adjustments (P = .002). CONCLUSION Advancing parity is associated with an increased risk for high serum concentrations of antithyroid peroxidase antibodies. This suggests fetal microchimerism may play a role in development of autoimmune thyroid disorders.
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The unexplained female predominance of systemic lupus erythematosus: clues from genetic and cytokine studies. Clin Rev Allergy Immunol 2011; 40:42-9. [PMID: 20063186 DOI: 10.1007/s12016-009-8192-4] [Citation(s) in RCA: 171] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Despite recent progress in the understanding of systemic lupus erythematosus (SLE), the striking 9:1 female to male ratio of disease incidence remains largely unexplained. In addition, peak SLE incidence rates occur during the early reproductive years in women. Studies which illuminate potential causes underlying this sex difference and characteristic onset during the reproductive years have the potential to fundamentally advance our understanding of disease pathogenesis in SLE. Similarly, progress in this area will likely inform human reproductive immunology. Studies of sex hormone function in the immune system are of obvious importance; however, it seems likely that many other types of sex-related genetic and immunological differences will contribute to SLE. In this review, we will focus on recent work in sex-related differences in cytokine pathways and genetics of these pathways as they relate to SLE pathogenesis. It seems quite possible that many of these sex-related differences could be important to reproductive fitness, which may explain the conservation of these immune system features and the observed female predominance of SLE.
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Abstract
Fetal cell microchimerism is defined as the persistence of fetal cells in the mother after birth without any apparent rejection. Fetal microchimeric cells (FMCs) engraft into the maternal bone marrow for decades after delivery and are able to migrate to blood and tissues. This phenomenon was hypothesized to have a detrimental role in autoimmune diseases, but data are still controversial and debated. In malignant tumors, fetal cell microchimerism has been postulated to have a positive effect on tumor burden, although some evidence suggests that FMCs may be involved in neoplastic progression. At the peripheral level, circulating FMCs are less frequently detected in patients with thyroid cancer, breast cancer or other solid, hematologic malignancies than in healthy individuals, which suggests a protective role for fetal cell microchimerism. In tissues, FMCs have been found in tumor sections from malignancies such as thyroid, breast, cervix, lung cancers and melanomas and have been shown to differentiate into epithelial, hematopoietic, endothelial and mesenchymal cells. FMCs with hematopoietic differentiation have been postulated to have a role in destroying the tumor, whereas mesenchymal and epithelial cells could participate in repair processes. Endothelial cells, on the other hand, are believed to play a part in tumor progression. This Review provides an overview of the role of fetal cell microchimerism in autoimmune and benign or malignant nonautoimmune diseases. Moreover, the mechanisms by which fetal cell microchimerism is believed to modulate the protection against cancer or tumor progression will be discussed, together with future research directions.
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Affiliation(s)
- Laura Fugazzola
- Endocrine Unit, Fondazione IRCCS Ca' Granda, Università degli Studi di Milano, Via Francesco Sforza 35, 20122 Milan, Italy.
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Samura O. [Fetal microchimerism and autoimmune disease]. NIHON RINSHO MEN'EKI GAKKAI KAISHI = JAPANESE JOURNAL OF CLINICAL IMMUNOLOGY 2011; 33:293-303. [PMID: 21212581 DOI: 10.2177/jsci.33.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Microchimerism is defined by the presence of circulating cells, bi-directionally transferred from one genetically distinct individual to another. The acquisition and persistence of fetal cell microchimerism, small numbers of genetically disparate cells from the fetus in the mother, is now a well-recognized consequence of normal pregnancy. Some of the autoimmune diseases that show a predilection for women in their child-bearing years and beyond are linked to fetal microchimerism from previous pregnancies. Microchimerism has been investigated in different autoimmune disorders, such as systemic sclerosis, systemic lupus erythematosus, autoimmune thyroid diseases, and primary biliary cirrhosis. Recent data have demonstrated the promising role of microchimeric cells in the maternal response to tissue injuries by differentiating into many lineages. Therefore, further understanding of fetal-maternal microchimerism may help in anticipating its implications in disease as well as in more general women's health issues.
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Affiliation(s)
- Osamu Samura
- Department of Obstetrics and Gynecology, NHO Kure Medical Center and Chugoku Cancer Center, Kure, Japan
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Zeng XX, Tan KH, Yeo A, Sasajala P, Tan X, Xiao ZC, Dawe G, Udolph G. Pregnancy-associated progenitor cells differentiate and mature into neurons in the maternal brain. Stem Cells Dev 2010; 19:1819-30. [PMID: 20707697 DOI: 10.1089/scd.2010.0046] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Bidirectional cell trafficking between fetus and mother during pregnancy is a well-established phenomenon observed in placental vertebrates including humans. Although studies have shown that transmigratory fetal cells, also termed pregnancy-associated progenitor cells (PAPCs), can integrate into multiple maternal organs, the integration, long-term survival, and differentiation of PAPCs in the brain has not been extensively studied. Using a murine model of fetomaternal microchimerism, we show that PAPCs integrated and persisted in several areas of the maternal brain for up to 7 months postpartum. Besides expressing neural stem cell or immature neuronal markers, PAPCs were observed to express mature neuronal markers, indicating that PAPCs adopted a neuronal fate. Further, PAPCs also displayed morphologically neuronal maturation by an increasing axonal/dendritic complexity over time. Therefore, PAPCs seem to undergo a molecular and morphological maturation program similar to that observed during adult neurogenesis. We provide evidence that neuronal gene expression of PAPCs was not a consequence of cell fusion with maternal neurons. In addition, in mothers with experimentally induced Parkinson's disease (PD), the frequency of PAPCs within the hippocampus initially increased whereas long-term presence of PAPCs was compromised. Also, the spatial distribution of PAPCs within the hippocampus was altered in mothers with PD. Thus, the disease context influenced the initial attraction, long-term survival, and spatial distribution of PAPCs, which may have wider implications on cell replacement strategies in human neurodegenerative diseases such as PD.
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Jonsson AM, Papadogiannakis N, Granath A, Haggstrom J, Schaffer M, Uzunel M, Westgren M. Maternal microchimerism in juvenile tonsils and adenoids. Pediatr Res 2010; 68:199-204. [PMID: 20531252 DOI: 10.1203/pdr.0b013e3181eb2eb4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
During pregnancy small amounts of cells pass between the mother and the fetus, and this transfer may give rise to a chimeric state that persist for years in both individuals. Both fetal and maternal microchimerism (MMc) have been associated with different autoimmune disorders. Information about MMc in tissues of healthy individuals is sparse but is important when looking for maternal cells within affected tissues of certain diseases. The aim of this study was to investigate the occurrence of maternal cells in tonsils and adenoids of 20 healthy children between the ages of 2 and 15 years. All the children underwent surgery because of recurrent tonsillitis or respiratory obstruction. MMc was detected using an RT-PCR assay based on differences in gene polymorphisms between mother and child. We found maternal cells in the tonsils and/or adenoids in four of 20 children. This frequency is less than the frequency of maternal cells found in the peripheral blood of healthy adults but in agreement with the previously reported frequency of maternal chimerism in control tissues
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Affiliation(s)
- Anna Maria Jonsson
- Department of Obstetrics and Gynecology, Karolinska Institute and Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden.
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Cirello V, Perrino M, Colombo C, Muzza M, Filopanti M, Vicentini L, Beck-Peccoz P, Fugazzola L. Fetal cell microchimerism in papillary thyroid cancer: studies in peripheral blood and tissues. Int J Cancer 2010; 126:2874-8. [PMID: 19856309 DOI: 10.1002/ijc.24993] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Fetal cell microchimerism (FCM) is defined as the persistence, for decades after pregnancy, of fetal cells in maternal organs and circulation without any apparent rejection. We recently reported evidence, in papillary thyroid cancer (PTC) tissues, supporting a possible role of FCM in tumor damage and repair. To extend those data at the peripheral level, 106 women with a previous male pregnancy, comprising 57 with PTC and 49 healthy controls were enrolled. The presence of circulating male DNA was assessed by the amplification of the Y chromosome-specific gene SRY, with a sensitivity of 1 male cell per 1 million female cells. Moreover, to compare the microchimeric status in blood and in tumors, the neoplastic tissues of 19 women were studied. At the blood level, a significantly lower frequency of FCM was found in parous women with PTC with respect to controls (49.1% vs. 77.6%; p = 0.002). By PCR, male DNA was identified in the tumor tissues of 6 patients, and FISH analyses confirmed the presence of microchimeric cells (range 2.1-6.9 cells/section). In some patients, FCM was negative in the blood, whereas microchimeric cells were identified in the tumor. In conclusion, the prevalence of FCM in peripheral blood was found to be significantly lower in patients than in healthy controls. The presence of microchimeric cells in the tumors, but not at the peripheral level, supports the hypothesis that fetal cells could reside in maternal niches and could be recruited to diseased areas, where they could differentiate to regenerate damaged tissues.
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Affiliation(s)
- Valentina Cirello
- Department of Medical Sciences, University of Milan and Endocrine Unit, Fondazione Policlinico IRCCS, Via F. Sforza 35, Milan, Italy
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Gammill HS, Nelson JL. Naturally acquired microchimerism. THE INTERNATIONAL JOURNAL OF DEVELOPMENTAL BIOLOGY 2010; 54:531-43. [PMID: 19924635 DOI: 10.1387/ijdb.082767hg] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Bi-directional transplacental trafficking occurs routinely during the course of normal pregnancy, from fetus to mother and from mother to fetus. In addition to a variety of cell-free substances, it is now well recognized that some cells are also exchanged. Microchimerism refers to a small number of cells (or DNA) harbored by one individual that originated in a genetically different individual. While microchimerism can be the result of iatrogenic interventions such as transplantation or transfusion, by far the most common source is naturally acquired microchimerism from maternal-fetal trafficking during pregnancy. Microchimerism is a subject of much current interest for a number of reasons. During pregnancy, fetal microchimerism can be sought from the mothers blood for the purpose of prenatal diagnosis. Moreover, studies of fetal microchimerism during pregnancy may offer insight into complications of pregnancy, such as preeclampsia, as well as insights into the pathogenesis of autoimmune diseases such as rheumatoid arthritis which usually ameliorates during pregnancy. Furthermore, it is now known that microchimerism persists decades later, both fetal microchimerism in women who have been pregnant and maternal microchimerism in her progeny. Investigation of the long-term consequences of fetal and maternal microchimerism is another exciting frontier of active study, with initial results pointing both to adverse and beneficial effects. This review will provide an overview of microchimerism during pregnancy and of current knowledge regarding long-term effects of naturally acquired fetal and maternal microchimerism.
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Affiliation(s)
- Hilary S Gammill
- Department of Clinical Research, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington, USA.
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Abstract
During pregnancy there is transplacental traffic of fetal cells into the maternal circulation. Remarkably, cells of fetal origin can then persist for decades in the mother and are detectable in the circulation and in a wide range of tissues. Maternal CD8 T cell responses directed against fetal antigens can also be detected following pregnancy. However, the impact that the persistence of allogenic cells of fetal origin and the maternal immune response towards them has on the mother's health remains unclear and is the subject of considerable investigation. The potentially harmful effects of fetal microchimerism include an association with autoimmune disease and recurrent miscarriage. Beneficial effects that have been explored include the contribution of persistent fetal cells to maternal tissue repair. A link between fetal microchimerism and cancer has also been proposed, with some results supporting a protective role and others, conversely, suggesting a role in tumour development. The phenomenon of fetal microchimerism thus provokes many questions and promises to offer further insights not only into the biology of pregnancy but fields such as autoimmunity, transplantation biology and oncology.
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Oliver JE, Silman AJ. Why are women predisposed to autoimmune rheumatic diseases? Arthritis Res Ther 2009; 11:252. [PMID: 19863777 PMCID: PMC2787267 DOI: 10.1186/ar2825] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The majority of autoimmune diseases predominate in females. In searching for an explanation for this female excess, most attention has focused on hormonal changes - both exogenous changes (for example, oral contraceptive pill) and fluctuations in endogenous hormone levels particularly related to menstruation and pregnancy history. Other reasons include genetic differences, both direct (influence of genes on sex chromosomes) and indirect (such as microchimerism), as well as gender differences in lifestyle factors. These will all be reviewed, focusing on the major autoimmune connective tissue disorders: rheumatoid arthritis, systemic lupus erythematosus and scleroderma.
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Klonisch T, Drouin R. Fetal-maternal exchange of multipotent stem/progenitor cells: microchimerism in diagnosis and disease. Trends Mol Med 2009; 15:510-8. [PMID: 19828378 DOI: 10.1016/j.molmed.2009.09.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 09/03/2009] [Accepted: 09/03/2009] [Indexed: 12/17/2022]
Abstract
The biological concept of microchimerism, the bidirectional trafficking and stable long-term persistence of small numbers of allogeneic (fetal and maternal) cells in a genetically different organ, has gained considerable attention. Microchimerism is a common phenomenon in many species, including humans, and microchimeric cells can modify immunological recognition or tolerance, affect the course and outcome of various diseases and demonstrate stem cell-like or regenerative potential. Here, we review current knowledge of the biology of microchimerism and show how long-term allogeneic co-existence within an organism can impact on existing paradigms in chronic disease, cancer biology, regenerative medicine and fetal-maternal immunology. We discuss diagnostic challenges, clinical applications and future research directions in this exciting and rapidly emerging field of allogeneic fetal-maternal cell exchange.
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Affiliation(s)
- Thomas Klonisch
- Departments of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, MB, Canada.
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Fugazzola L, Cirello V, Beck-Peccoz P. Fetal cell microchimerism in human cancers. Cancer Lett 2009; 287:136-41. [PMID: 19541407 DOI: 10.1016/j.canlet.2009.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 05/14/2009] [Accepted: 05/15/2009] [Indexed: 11/30/2022]
Abstract
The transfer of fetal cells into the maternal circulation occurs normally during pregnancy and the post-partum persistence of these cells in the maternal blood and tissues, known as fetal cell microchimerism, has been clearly demonstrated. However, the long-term consequences of this phenomenon are only beginning to be appreciated. In particular, whether microchimerism could be involved in the carcinogenetic process or whether fetal microchimeric cells could be able to differentiate in host tissues, participating in the maternal response to injury, is still matter of study. In this review, the possible role and the consequences of fetal cell microchimerism, as emerged from studies in animal models and in women with different types of cancer, will be presented.
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Affiliation(s)
- Laura Fugazzola
- Department of Medical Sciences, University of Milan and Endocrine Unit, Fondazione Policlinico IRCCS, Milan, Italy.
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29
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Parant O, Khosrotehrani K, Aractingi S. Microchimérisme postgestationnel en pathologie humaine. Presse Med 2009; 38:584-90. [DOI: 10.1016/j.lpm.2008.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 05/19/2008] [Accepted: 05/27/2008] [Indexed: 10/20/2022] Open
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Stevens AM, Hermes HM, Kiefer MM, Rutledge JC, Nelson JL. Chimeric maternal cells with tissue-specific antigen expression and morphology are common in infant tissues. Pediatr Dev Pathol 2009; 12:337-46. [PMID: 18939886 PMCID: PMC2783488 DOI: 10.2350/08-07-0499.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Maternal microchimerism (MMc) has been purported to play a role in the pathogenesis of autoimmunity, but how a small number of foreign cells could contribute to chronic, systemic inflammation has not been explained. Reports of peripheral blood cells differentiating into tissue-specific cell types may shed light on the problem in that chimeric maternal cells could act as target cells within tissues. We investigated MMc in tissues from 7 male infants. Female cells, presumed maternal, were characterized by simultaneous immunohistochemistry and fluorescence in situ hybridization for X- and Y-chromosomes. Maternal cells constituted 0.017% to 1.9% of parenchymal cells and were found in all infants in liver, pancreas, lung, kidney, bladder, skin, and spleen. Maternal cells were differentiated: maternal hepatocytes in liver, renal tubular cells in kidney, and beta-islet cells in pancreas. Maternal cells were not found in areas of tissue injury or inflammatory infiltrate. Maternal hematopoietic cells were found only in hearts from patients with neonatal lupus. Thus, differentiated maternal cells are present in multiple tissue types and occur independently of inflammation or tissue injury. Loss of tolerance to maternal parenchymal cells could lead to organ-specific "auto" inflammatory disease and elimination of maternal cells in areas of inflammation.
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Affiliation(s)
- Anne M. Stevens
- Center for Immunity and Immunotherapy, Children’s Hospital Research Institute, Seattle, WA, USA, 98101, Seattle Children’s Hospital, Seattle, WA, USA, 98105, Department of Pediatrics, University of Washington, Seattle, WA, USA, 98195, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, 98109,Corresponding Author: Anne M. Stevens, MD, PhD, Seattle Children’s Hospital Research Institute, 1900 Ninth Avenue, C9S-7, Seattle, WA 98101-1304, , Telephone: (206) 987-7313, Fax: (206) 987-7310
| | - Heidi M. Hermes
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA, 98109
| | | | - Joe C. Rutledge
- Seattle Children’s Hospital, Seattle, WA, USA, 98105, Department of Laboratory Medicine, University of Washington, Seattle, WA, USA, 98195
| | - J. Lee Nelson
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA, 98109, Department of Medicine, University of Washington, Seattle, WA, USA, 98195
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Transdifferentiation of stem cells: a critical view. ADVANCES IN BIOCHEMICAL ENGINEERING/BIOTECHNOLOGY 2009; 114:73-106. [PMID: 19343303 DOI: 10.1007/10_2008_49] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Recently a large amount of new data on the plasticity of stem cells of various lineages have emerged, providing new perspectives especially for the therapeutic application of adult stem cells. Previously unknown possibilities of cell differentiation beyond the known commitment of a given stem cell have been described using keywords such as "blood to liver," or "bone to brain." Controversies on the likelihood, as well as the biological significance, of these conversions almost immediately arose within this young field of stem cell biology. This chapter will concentrate on these controversies and focus on selected examples demonstrating the technical aspects of stem cell transdifferentiation and the evaluation of the tools used to analyze these events.
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O'Donoghue K. Fetal microchimerism and maternal health during and after pregnancy. Obstet Med 2008; 1:56-64. [PMID: 27582787 DOI: 10.1258/om.2008.080008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2008] [Indexed: 01/24/2023] Open
Abstract
Trafficking of fetal cells into the maternal circulation begins very early in pregnancy and the effects of this cell traffic are longlasting. All types of fetal cells, including stem cells, cross the placenta during normal pregnancy to enter maternal blood, from where they may be recovered in pregnancy for the purpose of genetic prenatal diagnosis. Fetal cells can also be located in maternal tissues during and after pregnancy, and persist as microchimeric cells for decades in marrow and other organs. Although persistent fetal cells were first implicated in autoimmune disease, subsequent reports routinely found microchimeric cells in healthy tissues and in non-autoimmune disease. Parallel studies in animal and human pregnancy now suggest instead that microchimeric fetal cells play a role in the response to tissue injury. However, it is still not clear whether microchimeric fetal cells persisting in the mother are an incidental finding, are naturally pathogenic or act as reparative stem cells, and the environmental or biological stimuli that determine microchimeric cell fate are as yet undetermined. Future studies must also focus on investigating whether fetal cells create functional improvement in response to maternal injury and whether this response can be manipulated. The pregnancy-acquired low-grade chimeric state of women could have far-reaching implications, influencing recovery after injury or surgery, ageing, graft survival after transplantation, survival after cancer as well as deciding the protective effect of pregnancy against diseases later in life. Lifelong persistence of fetal cells in maternal tissues may even explain why women live longer than men.
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Affiliation(s)
- Keelin O'Donoghue
- Department of Obstetrics and Gynaecology , University College Cork, Cork University Maternity Hospital , Wilton, Cork , Republic of Ireland
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Cirello V, Recalcati MP, Muzza M, Rossi S, Perrino M, Vicentini L, Beck-Peccoz P, Finelli P, Fugazzola L. Fetal cell microchimerism in papillary thyroid cancer: a possible role in tumor damage and tissue repair. Cancer Res 2008; 68:8482-8. [PMID: 18922922 DOI: 10.1158/0008-5472.can-08-0672] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fetal cells enter the maternal circulation during pregnancy and can persist in the maternal blood or tissues for decades, creating a physiologic microchimerism. Because papillary thyroid cancer (PTC) is more frequent in women, the role of persisting fetal male cells in this tumor has been investigated. Tumor tissue specimens were obtained from 63 women with PTC who had a male pregnancy before the diagnosis. Male cells, identified by PCR amplification of a male-specific gene, the sex-determining region Y, was detected in 47.5% of women. By fluorescence in situ hybridization (FISH) analyses, the total number of microchimeric cells was significantly higher in neoplastic tissue than in controlateral normal sections. By combined FISH and immunohistochemistry (immuno-FISH), male cells expressing thyroglobulin were found in tumor and normal tissues, whereas male microchimeric cells stained with the CD45 antigen were detected only in tumor sections. Microchimeric cells negative for either marker were detected both in tumor and normal tissues. Moreover, both CD45(+) and Tg(+) fetal cells did not express MHC II antigens. In conclusion, fetal microchimerism has been documented in a high proportion of women with PTC. The immuno-FISH studies indicate that CD45(+)/MHC II(-) male cells found in neoplastic tissues might be committed to destroy tumor cells, whereas Tg(+)/MHC II(-) cells could have a repair function. Finally, microchimeric cells negative for either CD45 or Tg could have "progenitor-like" properties able to transdifferentiate in different cellular types. Although a pathogenetic mechanism cannot be excluded, the whole of the present results indicates a protective role of microchimerism in thyroid cancer.
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Affiliation(s)
- Valentina Cirello
- Department of Medical Sciences and Endocrine Unit, University of Milan, Milan Italy
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34
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Kremer Hovinga ICL, Koopmans M, Grootscholten C, van der Wal AM, Bijl M, Derksen RHWM, Voskuyl AE, de Heer E, Bruijn JA, Berden JHM, Bajema IM. Pregnancy, chimerism and lupus nephritis: a multi-centre study. Lupus 2008; 17:541-7. [PMID: 18539707 DOI: 10.1177/0961203308089324] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chimerism occurs twice as often in the kidneys of women with lupus nephritis as in normal kidneys and may be involved in the pathogenesis of systemic lupus erythematosus. Pregnancy is considered the most important source of chimerism, but the exact relationship between pregnancy, the persistence of chimeric cells and the development of systemic lupus erythematosus has not been investigated. Renal biopsies and clinical data from patients in the First Dutch Lupus Nephritis Study were used. Chimeric cells were identified by in-situ hybridization of the Y chromosome. A questionnaire was used to obtain detailed reproductive data including pregnancy history and miscarriages. Chimerism was found in 12 of 26 (46%) renal biopsies. Of the 12 chimeric women, 5 reported a pregnancy; of 14 women who were not chimeric, 8 reported a pregnancy. Chimeric women who had been pregnant reported significantly more pregnancies than non-chimeric women who had been pregnant (P=0.04). The median age of the youngest child was higher in chimeric women (19 years) than in non-chimeric women (6 years). Despite the attention given to pregnancy histories with respect to chimerism, this study shows that in patients with systemic lupus erythematosus, a clear-cut relationship is not apparent. A considerable number of chimeric women did not report a pregnancy: in these women, other sources of chimerism must be considered. Our data support the theory that only certain subsets of chimeric cells persist into the maternal circulation after pregnancy.
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Affiliation(s)
- I C L Kremer Hovinga
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands.
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Koopmans M, Kremer Hovinga ICL, Baelde HJ, Harvey MS, de Heer E, Bruijn JA, Bajema IM. Chimerism occurs in thyroid, lung, skin and lymph nodes of women with sons. J Reprod Immunol 2008; 78:68-75. [PMID: 18329105 DOI: 10.1016/j.jri.2008.01.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Revised: 12/12/2007] [Accepted: 01/07/2008] [Indexed: 02/05/2023]
Abstract
Chimerism indicates the presence of cells from one individual in another. Pregnancy and blood transfusions are considered the main sources for chimerism. Chimeric cells have been attributed a pathogenic role in various autoimmune diseases. However, data on the occurrence of chimeric cells in normal organs are scarce. In order to gain insight into the possible pathogenic potential of chimeric cells in autoimmune disease, it is necessary to determine the prevalence of chimeric cells in organs not affected by autoimmune disease. In situ hybridization for the Y-chromosome was performed on organs obtained at autopsy of 51 women. We investigated 44 thyroid, 38 lung, 21 skin and 7 lymph node samples. All women had sons, and data from their blood transfusion histories were retrieved for at least 10 years before death. Slides were scored semi-quantitatively for chimerism as low (1-3 Y-chromosome-positive cells per slide), moderate (4-10 positive cells per slide) or high (more than 10 positive cells per slide). Y-chromosome-positive cells were found in 8 thyroid, 10 lung, 3 skin and 1 lymph node samples of 18 women. There was no association between the presence of chimeric cells and blood transfusion history. Most organs in which chimerism was present contained a small to moderate level. Thus, chimerism can occur in normal organs of women without autoimmune disease. Our results indicate that chimerism is not necessarily associated with disease.
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Affiliation(s)
- Marije Koopmans
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
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36
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Abstract
There is increasing evidence that both circulating cells and free fetal DNA persist in the maternal circulation after delivery of the fetus. In some cases, this has been described many years after the end of the pregnancy. This article reviews the evidence for these cells being present, the potential methodologies used to identify such cells and the potential effects on maternal immunomodulation. Data relating to the potential beneficial and potentially harmful effects are discussed.
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Affiliation(s)
- D Lissauer
- Fetal Medicine Centre, Division of Reproduction and Child Health, Birmingham Women's Hospital, Birmingham, UK
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37
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Bauer M, Weger W, Orescovic I, Hiebaum EM, Benedicic C, Lang U, Pertl C, Pertl B. Fetal microchimerism is not involved in the pathogenesis of lichen sclerosus of the vulva. Prenat Diagn 2007; 26:175-8. [PMID: 16470677 DOI: 10.1002/pd.1372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The aim of this study was to investigate a possible relationship between fetal cell microchimerism and lichen sclerosus of the vulva. We searched for the presence of male cells and DNA in vulval tissue samples. METHODS Paraffin-embedded skin biopsy samples from 15 women affected with vulval lichen sclerosus who gave birth to at least one son were analyzed for the presence of microchimeric male cells using fluorescence in situ hybridization (FISH) and fluorescent PCR. We included three lichen sclerosus samples originating from women without male offspring, six vulval specimens without pathological finding originating from autopsies and seven male gingival specimens as controls. RESULTS Nucleated cells containing Y-chromosome specific sequences were neither detected at any site of the lesions nor in normal vulval specimens by using FISH. These results were confirmed by the use of PCR amplification demonstrating only DNA sequences specific for the X chromosome. No female microchimerism was detected in the male gingival samples. CONCLUSION Despite the limited number and size of the samples, we conclude that persistent male fetal cells are not involved in the pathogenesis of lichen sclerosus of the vulva, since we consistently could not detect Y-chromosome specific sequences by using two molecular techniques.
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Affiliation(s)
- Margit Bauer
- Department of Obstetrics and Gynaecology, Medical University Graz, Austria
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38
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Bustos ML, Frías S, Ramos S, Estrada A, Arreola JL, Mendoza F, Gaxiola M, Salcedo M, Pardo A, Selman M. Local and Circulating Microchimerism Is Associated with Hypersensitivity Pneumonitis. Am J Respir Crit Care Med 2007; 176:90-5. [PMID: 17431225 DOI: 10.1164/rccm.200608-1129oc] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
RATIONALE Hypersensitivity pneumonitis (HP) is a lymphocytic alveolitis provoked by exposure to a variety of antigens. However, the disease occurs in only a subset of exposed individuals, suggesting that additional factors may be involved. Microchimerism has been implicated in the pathogenesis of autoimmune diseases, especially in those showing increased incidence after childbearing age. OBJECTIVES To evaluate the presence of circulating and local microchimeric cells in female patients with HP. METHODS Male microchimerism was examined in 103 patients with HP, 30 with idiopathic pulmonary fibrosis (IPF), and 43 healthy women. All of them had given birth to at least one son, with no twin siblings, blood transfusions, or transplants. Microchimerism was examined by dot blot hybridization (peripheral blood), and by fluorescence in situ hybridization in bronchoalveolar lavage cells and lungs. MEASUREMENTS AND MAIN RESULTS Blood microchimerism was found in 33% of the patients with HP in comparison with 10% in those with IPF (p = 0.019) and 16% in healthy women (p = 0.045). Patients with HP with microchimerism showed a significant reduction of diffusing capacity of carbon monoxide (Dl(CO); 53.5 +/- 11.9% vs. 65.2 +/- 19.7%; p = 0.02) compared with patients with HP without microchimerism. In bronchoalveolar lavage cells, microchimerism was detected in 9 of 14 patients with HP compared with 2 of 10 patients with IPF (p = 0.047). Cell sorting revealed that microchimeric cells were either macrophages or CD4+ or CD8+ T cells. Male microchimeric cells were also found in the five HP lungs examined by fluorescence in situ hybridization. CONCLUSIONS Our findings (1) demonstrate that patients with HP exhibit increased frequency of fetal microchimerism, (2) confirm the multilineage capacity of microchimeric cells, and (3) suggest that microchimeric cells may increase the severity of the disease.
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Affiliation(s)
- Martha L Bustos
- Instituto Nacional de Enfermedades Respiratorias, Mexico, DF, Mexico
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39
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Kremer Hovinga ICL, Koopmans M, Baelde HJ, de Heer E, Bruijn JA, Bajema IM. Tissue chimerism in systemic lupus erythematosus is related to injury. Ann Rheum Dis 2007; 66:1568-73. [PMID: 17584805 PMCID: PMC2095333 DOI: 10.1136/ard.2007.070516] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Chimerism indicates the presence of cells from one individual in another individual, and has been associated with several autoimmune diseases. Although this finding may point towards a role for chimerism in the induction of SLE, it could also indicate that chimerism is the result of repair mechanisms after injury. OBJECTIVE To perform a post-mortem investigation for the presence of chimerism in 48 organs from seven women with SLE and establish whether there was a relationship between chimerism and injury. METHODS Chimeric male cells in female tissue specimens were identified by in situ hybridisation of the Y-chromosome. Organs were categorised into four different groups according to injury experienced. RESULTS were compared with those for unaffected control organs. Results: Chimerism was found in all seven patients with SLE. Y-chromosome-positive cells were present in 24 of 48 organs from women with SLE, which was significantly more than in control organs (p<0.001). Chimerism occurred more often in organs from patients with SLE who had experienced injury than in normal control organs, irrespective of whether the injury experienced was SLE-related, non-SLE-related or both. CONCLUSIONS This is the first report of the distribution of chimerism in a large number of organs from women with SLE. It shows that the occurrence of chimerism is related to injury. The data support the hypothesis that tissue chimerism is the result of a repair process.
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Affiliation(s)
- Idske C L Kremer Hovinga
- Department of Pathology, Leiden University Medical Center, P0-14, PO Box 9600, 2300 RC Leiden, the Netherlands.
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Piper KP, McLarnon A, Arrazi J, Horlock C, Ainsworth J, Kilby MD, Martin WL, Moss PA. Functional HY-Specific CD8+ T Cells Are Found in a High Proportion of Women Following Pregnancy with a Male Fetus1. Biol Reprod 2007; 76:96-101. [PMID: 16988213 DOI: 10.1095/biolreprod.106.055426] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Recent studies have demonstrated that fetal cells can be detected in the maternal circulation during virtually all human pregnancies. These fetal cells can engraft and may be isolated for many decades after pregnancy, leading to a state that may be maintained by the passage of pregnancy-associated progenitor cells. The clinical consequences of fetal cell microchimerism are unclear but may be potentially detrimental or valuable to the mother. One possibility is the generation of an alloreactive immune response by the mother to antigens expressed by the fetus; for example, the HY protein encoded by the Y chromosome. To test this we have screened a cohort of women with a range of parity histories within 8 yr of their last pregnancy for the presence of an HY-specific CD8+ T-cell response. Fluorescent HLA-peptide (HY) tetramers were used to stain short-term T-cell cultures from these women for analysis by flow cytometry. Responses were detected in 37% of women with a history of pregnancies that produced males, and this value rose to 50% in women with two or more pregnancies that produced males. HY-specific CD8+ T cells also could be detected directly in the peripheral blood of women with a history of at least two pregnancies that produced males. These HY-specific CD8+ T cells produced interferon gamma (IFNG) following peptide stimulation, demonstrating their functional capacity. In conclusion, our data indicate that alloreactive CD8+ T cells are generated frequently following normal pregnancy and retain functional capability for years following pregnancy.
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Affiliation(s)
- Karen P Piper
- Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham Women's Hospital, Birmingham, B15 2TT United Kingdom.
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Bianchi DW. Robert E. Gross Lecture. Fetomaternal cell trafficking: a story that begins with prenatal diagnosis and may end with stem cell therapy. J Pediatr Surg 2007; 42:12-8. [PMID: 17208534 DOI: 10.1016/j.jpedsurg.2006.09.047] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Diana W Bianchi
- Division of Genetics, Department of Pediatrics, The Floating Hospital for Children and Tufts-New England Medical Center, Boston, MA 02111, USA.
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42
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Kremer Hovinga ICL, Koopmans M, de Heer E, Bruijn JA, Bajema IM. Chimerism in systemic lupus erythematosus—three hypotheses. Rheumatology (Oxford) 2006; 46:200-8. [PMID: 17135226 DOI: 10.1093/rheumatology/kel379] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Systemic lupus erythematosus (SLE) is an immune-mediated disease characterized by the presence of autoantibodies and a wide array of clinical symptoms. Despite intensive research, the aetiology of SLE is still unknown and is probably multifactorial. Both genetic and environmental factors have been associated with SLE, but these factors alone are insufficient to explain the onset of SLE. Recently, it has been suggested that chimerism plays a role in the pathogenesis of autoimmune diseases, including SLE. Chimerism indicates the presence of cells from one individual in another individual. In an experimental mouse model, the injection of chimeric cells induces a lupus-like disease. In addition, chimerism is found more often in kidneys of women with SLE than in healthy controls. There are several mechanisms by which chimeric cells could be involved in the pathogenesis of SLE. In this review, three hypotheses on the role of chimerism in SLE are discussed. The first two hypotheses describe the possibilities that chimeric cells induce either a graft-vs-host reaction in the host (comparable with reactions seen after bone marrow transplantation) or a host-vs-graft reaction (comparable with reactions seen after solid organ transplantation). The third hypothesis discusses the possible beneficial role chimeric cells may play in repair mechanisms due to their stem cell-like properties. This review provides insights into the mechanisms by which chimerism may be involved in SLE and proposes several lines of inquiry to further investigate chimerism in SLE.
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Affiliation(s)
- I C L Kremer Hovinga
- Department of Pathology, Leiden University Medical Center, P0-14, PO Box 9600, 2300 RC Leiden, The Netherlands.
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Kremer Hovinga ICL, Koopmans M, Baelde HJ, van der Wal AM, Sijpkens YWJ, de Heer E, Bruijn JA, Bajema IM. Chimerism occurs twice as often in lupus nephritis as in normal kidneys. ACTA ACUST UNITED AC 2006; 54:2944-50. [PMID: 16948133 DOI: 10.1002/art.22038] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) is an immune-mediated disease that particularly affects the kidneys, causing lupus nephritis. In experimental mouse models, lupus nephritis can be mimicked by inducing a chimeric state through the injection of parental T cells in offspring. In humans, pregnancy-induced chimerism may play a role in the pathogenesis of autoimmune diseases such as SLE, but it is likely that only certain chimeric cells have pathogenic potential. In this study, we investigated whether the distribution of chimeric cells is different in the kidneys of women with SLE from that in normal kidneys, and we examined the phenotype of chimeric cells in women with SLE. METHODS The presence of chimeric cells was investigated by in situ hybridization targeting the Y chromosome in 57 renal biopsy samples from 49 women with lupus nephritis. Fifty-one kidney autopsy specimens without histomorphologic lesions served as controls. Double-staining for the Y chromosome in combination with CD3 and CD34 markers was performed in 5 kidney specimens with lupus nephritis to identify the phenotype of the chimeric cells. RESULTS Y chromosome-positive cells were found in 27 of 49 patients with lupus nephritis and in 13 of 51 normal controls (P < 0.01). Both CD3+ and CD34+ chimeric cells were identified in lupus nephritis kidney specimens. CONCLUSION Chimeric cells are present significantly more often in kidneys with lupus nephritis than in normal kidneys, and some of these chimeric cells are T cells. This finding is interesting in light of experimental models demonstrating that lupus nephritis is initiated by chimeric T cells.
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Jønsson V, Bock JE, Hilden J, Houlston RS, Wiik A. The influence of pregnancy on the development of autoimmunity in chronic lymphocytic leukemia. Leuk Lymphoma 2006; 47:1481-7. [PMID: 16966257 DOI: 10.1080/10428190600634135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To examine whether pregnancy influences the development of autoimmunity in chronic lymphocytic leukemia (CLL), we studied 591 consecutive CLL patients (202 post-menopausal women and 389 men). The mean observation time for all patients was 3.8 years, corresponding to approximately 2200 person-years of follow-up. Autoimmune manifestations were analyzed in 194 women with known obstetric history and known number of long-term sexual partners, and in the 389 male CLL patients for comparison. One hundred and fifty-nine of the CLL patients exhibited autoimmune manifestations, 38% in females and 21% in men. In female CLL patients, the frequency of autoimmunity and the number of pregnancies and the number of partners were strongly correlated. Each of the major autoimmune types approximately doubled in frequency for each additional pregnancy. The impact of pregnancy on expressed autoimmunity increased with each additional sexual partner (the odds of autoimmunity increased 11 times with each long-term sexual partner). The average numbers of pregnancies in female CLL patients with and without autoimmunity were 4.92 and 2.24, respectively (P < 0.001). Coombs' positive autoimmune anemia, a gastric ulcer with parietal cell autoantibodies and idiopathic thrombocytopenic purpura were equally common in women and men, whereas autoimmune thyroiditis, Sjögren's syndrome, rheumatoid arthritis and systemic lupus erythematosus were seen in higher rates in women than in men. The spectrum of autoimmunity suggests that pregnancy-related alloimmunization may be involved in the development of autoimmunity in CLL.
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MESH Headings
- Autoantibodies/blood
- Autoimmune Diseases/etiology
- Autoimmunity
- Female
- Follow-Up Studies
- Gravidity
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Male
- Pregnancy
- Pregnancy Complications, Neoplastic/immunology
- Sexual Behavior
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Affiliation(s)
- Viggo Jønsson
- Department of Hematology, Rigshospital, School of Medicine, University of Copenhagen, Copenhagen, Denmark.
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Huerta Sil G, Medrano Ramírez G. [Fetal microchimerism in rheumatic diseases]. ACTA ACUST UNITED AC 2006; 2:202-9. [PMID: 21794328 DOI: 10.1016/s1699-258x(06)73046-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2005] [Accepted: 09/20/2005] [Indexed: 11/16/2022]
Abstract
Fetal microchimerism is the presence of fetal cells inmaternal tissues and vice versa, i.e., the coexistence of2 different cellular populations from genetically differentindividuals within a single person. The most frequentcause of microchimerism is pregnancy, in which there is abi-directional fetal-maternal interchange of cells duringpregnancy and delivery. Fetal cells have been demonstrated in the tissues ofpatients with rheumatic, endocrine or infectious diseases,as well as in those of healthy individuals. Microchimerism has been most extensively studied insystemic sclerosis. It seems that during pregnancyallogenic fetal or maternal cells cross the placenta bidirectionallyand persist in the systemic circulation andtissues of both mother and child. Subsequently, they areactivated, resulting in is a graft-against-host reactionassociated with the onset of clinical manifestations.Microchimerism has been also studied in otherconnective tissue diseases.
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Stevens AM, Tsao BP, Hahn BH, Guthrie K, Lambert NC, Porter AJ, Tylee TS, Nelson JL. Maternal HLA class II compatibility in men with systemic lupus erythematosus. ACTA ACUST UNITED AC 2005; 52:2768-73. [PMID: 16142706 PMCID: PMC6663487 DOI: 10.1002/art.21256] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Maternal-fetal cell transfer during pregnancy can lead to long-lasting microchimerism, which raises the question of whether microchimerism sometimes contributes to autoimmune disease later in life. In an experimental model, transfusion of parental lymphocytes homozygous for major histocompatibility complex alleles results in systemic lupus erythematosus (SLE). We identified male patients with SLE and healthy male subjects and their mothers in order to investigate the mother-son HLA relationship in SLE risk. Male subjects were selected in order to avoid confounding due to fetal microchimerism, which may occur in women. METHODS HLA genotyping for DRB1, DQA1, and DQB1 was conducted for sons and their mothers. Thirty men with SLE and their mothers were compared with 76 healthy men and their mothers. RESULTS Sons with SLE were HLA-identical with their mothers (bidirectionally compatible) for the basic HLA-DRB1 groups encoded by DRB1*01 through DRB1*14 more often than were healthy sons (odds ratio [OR] 5.0, P = 0.006). Each DRB1 group contains multiple allelic variants; male patients with SLE and their mothers often were identical for both DRB1 allelic variants (OR 3.2, P = 0.08). For DQA1 and DQB1, the ORs were 2.3 (P = 0.08) and 2.0 (P = 0.21), respectively. When analysis was limited to male subjects with SLE-associated HLA genes (encoding HLA-DR2 or HLA-DR3), the differences further increased for DRB1 basic groups (OR 7.2, P = 0.01), DRB1 alleles (OR 15.0, P = 0.018), DQA1 6.4 (P = 0.006), and DQB1 (OR 5.7, P = 0.027). No increase in (unidirectional) compatibility of the mother from the son's perspective was observed at any locus. CONCLUSION We observed increased bidirectional HLA class II compatibility of male SLE patients and their mothers compared with healthy men and their mothers. This observation implies that maternal microchimerism could sometimes be involved in SLE and therefore merits further investigation.
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Affiliation(s)
- Anne M Stevens
- Fred Hutchinson Cancer Research Center and University of Washington, Seattle, USA.
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Guettier C, Sebagh M, Buard J, Feneux D, Ortin-Serrano M, Gigou M, Tricottet V, Reynès M, Samuel D, Féray C. Male cell microchimerism in normal and diseased female livers from fetal life to adulthood. Hepatology 2005; 42:35-43. [PMID: 15962317 DOI: 10.1002/hep.20761] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Male microchimerism is frequent in the adult female liver and is attributed to fetal cells originating from previous male offspring. It has never been studied in pregnant women, female children, or fetuses. We examined its frequency and cellular nature in normal and diseased female livers from fetal life to adulthood. Forty-six liver samples from 29 women, 6 female children, and 11 female fetuses were screened for the Y chromosome via polymerase chain reaction (PCR) assay and fluorescent in situ hybridization (FISH). The X chromosome was used as an internal control. A third PCR assay was used for Y genotyping. The Y chromosome was detected in 5 of 6 children, 7 of 11 fetuses, 3 of 9 women with normal liver, 7 of 10 women with chronic hepatitis C, 5 of 6 women with acute liver disease during pregnancy with male offspring, and 2 of 4 nonpregnant women with fulminant hepatitis. In positive samples, the mean XY/XX ratio was 0.012 (+/-0.004). In women, male microchimerism was correlated with previous male offspring. Male hepatocytes, detected via FISH combined with anti-hepatocyte immunohistochemistry, were observed only in fetuses (4/9) and in postpartem women (4/6). Y genotypes were different from each other in 4 of 5 female livers. In conclusion, male liver microchimerism is frequent in normal and diseased female livers. The presence of male cells in the liver of female children and fetuses is probably due to the transplacental transmission of fetal cells preexisting in the mother and acquired either from previous pregnancy with male offspring or during the mother's own fetal life.
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Affiliation(s)
- Catherine Guettier
- Service d'Anatomie Pathologique, Unité propre de recherche de l'enseignement supérieur (UPRES) N degree 3541, Université Paris XI, Hôpital Paul Brousse, Villejuif, France.
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Khosrotehrani K, Bianchi DW. Multi-lineage potential of fetal cells in maternal tissue: a legacy in reverse. J Cell Sci 2005; 118:1559-63. [PMID: 15811948 DOI: 10.1242/jcs.02332] [Citation(s) in RCA: 137] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Fetal cells circulate in pregnant women and persist in blood and tissue for decades post-partum. The mother thus becomes chimeric. Factors that may influence such fetal cell microchimerism include histocompatibility, fetal or placental abnormalities, or a reproductive history that includes miscarriage or elective termination. Fetal cell microchimerism is associated with some maternal autoimmune diseases, such as systemic sclerosis. Moreover, a novel population of fetal cells, the pregnancy-associated progenitor cells (PAPCs), appears to differentiate in diseased or injured maternal tissue. The cellular origin of these cells is at present unknown but could be a hematopoietic stem cell, a mesenchymal stem cell, or a novel cell type. Pregnancy therefore results in the acquisition of cells with stem-cell-like properties that may influence maternal health post-partum. Rather than triggering disease, these cells may instead combat it.
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Affiliation(s)
- Kiarash Khosrotehrani
- Department of Dermatology, Tenon Hospital and UPRES EA2396, Saint-Antoine School of Medicine, Pierre et Marie Curie (Paris VI) University, 75020 Paris, France
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Bianchi DW. Fetomaternal cell traffic, pregnancy-associated progenitor cells, and autoimmune disease. Best Pract Res Clin Obstet Gynaecol 2004; 18:959-75. [PMID: 15582549 DOI: 10.1016/j.bpobgyn.2004.06.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Fetal cells in maternal blood are a potential source of fetal genetic material that can be obtained non-invasively. Efforts to isolate these cells from maternal peripheral blood are limited by their low circulating numbers (approximately 1 per ml of maternal blood in euploid pregnancies). Expansion of these cells by culture would provide more cells for diagnosis and give an opportunity to study fetal metaphase chromosomes. Despite extensive optimization of culture conditions, many groups have failed reproducibly to grow fetal cells from pre-procedural maternal samples. An unexpected benefit of this research has been the discovery of a novel population of fetal cells, the pregnancy-associated progenitor cell (PAPC), which remains in maternal blood and tissue for decades following delivery. These cells might play a role in some autoimmune diseases, such as scleroderma. PAPCs appear to have stem cell characteristics, such as the ability to proliferate and differentiate. Recently developed animal models will help to ascertain whether these cells cause disease, respond to disease, or have therapeutic applications.
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Affiliation(s)
- Diana W Bianchi
- Division of Genetics, Departments of Pediatrics, Obstetrics and Gynecology, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.
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Reed AM, McNallan K, Wettstein P, Vehe R, Ober C. Does HLA-Dependent Chimerism Underlie the Pathogenesis of Juvenile Dermatomyositis? THE JOURNAL OF IMMUNOLOGY 2004; 172:5041-6. [PMID: 15067086 DOI: 10.4049/jimmunol.172.8.5041] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Juvenile dermatomyositis (JDM) is a multisystem autoimmune disease that at times resembles chronic graft-vs-host disease. This led us to suggest that nonself cells may play a role in the disease process. In this study we examined the relationship between HLA genotype and the presence of maternally derived chimeric cells in JDM patients and healthy controls, and assessed immunologic activity in the chimeric cells. We identified chimeric cells more often in children with JDM (60 of 72) than in their unaffected siblings (11 of 48) or in healthy controls (5 of 29). The presence of chimerism in the JDM patients, their healthy siblings, and unaffected control children was associated with a HLA-DQA1*0501 allele in the mother (p = 0.011). Further, we show that maternally transferred chimeric T cells are responsive to the host's (JDM childs') lymphocytes (33.75 +/- 8.4 IFN-gamma-producing cells from JDM cells vs 5.0 +/- 1.25 from maternal cells), and that this is a memory response. These combined data indicate that chimeric cells play a direct role in the JDM disease process and that the mother's HLA genotype facilitates the transfer and/or persistence of maternal cells in the fetal circulation.
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Affiliation(s)
- Ann M Reed
- Division of Rheumatology, Department of Medicine, Mayo Clinic and Medical School, Rochester, MN 55905, USA.
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