Perforin-expressing granulated metrial gland cells in murine deciduoma

Natural cytotoxicity receptor 1 in mouse uNK cell maturation and function

Early and midgestational decidua of mice genetically ablated for expression of the natural killer (NK) cell natural cytotoxicity receptor (NCR; Ncr1^Gfp/Gfp mice) shows restricted angiogenesis and atypically small uterine (u)NK cells. We hypothesized that NCR1 inactivation disturbs maturation and angiokine production by uterine natural killer (uNK) cells. Using histological and morphometric approaches, we observed that Ncr1^Gfp/Gfp but not control C57BL/6 (B6) implantation sites sustain immature, non-granulated uNK cells into midpregnancy. Mouse uNK cells can be subclassified by their reactivity with Dolichos biflorus agglutinin (DBA) lectin; DBA+ uNK cells with greater Ncr1 expression were investigated. DBA+ uNK cells from Ncr1^Gfp/Gfp mice show delayed maturation as indicated by shorter diameters and fewer cytoplasmic granules. Granules in mature Ncr1^Gfp/Gfp uNK cells are ultrastructurally abnormal and abundance of granule-associated proteins (perforin, granzyme) and of cytoplasmic proteins (vascular endothelial growth factor; placental growth factor) differs from controls. Leukocyte-leukocyte conjugate formation in gestation day 6.5 and 8.5 intact Ncr1^Gfp/Gfp decidua was less frequent than in B6; however, this difference involved leukocytes other than DBA+ uNK cells. These studies strongly support roles for NCR1 and its ligands in normal pregnancy promotion.

Ly49 receptors activate angiogenic mouse DBA⁺ uterine natural killer cells

In humans, specific patterns of killer immunoglobulin-like receptors (KIRs) expressed by uterine natural killer (uNK) cells are linked through HLA-C with pregnancy complications (infertility, recurrent spontaneous abortion, intrauterine growth restriction and preeclampsia). To identify mechanisms underpinning the associations between NK cell activation and pregnancy success, pregnancies were studied in mice with genetic knockdown (KD) of the MHC-activated Ly49 receptor gene family. B6.Ly49(KD) pregnancies were compared to normal control B6.Ly49(129) and C57BL/6 (B6) pregnancies. At mid-pregnancy (gestation day (gd9.5)), overall uNK cell (TCRβ(-)CD122(+)DBA(+)DX5(-) (DBA(+)DX5(-))) and TCRβ(-)CD122(+)DBA(-)DX5(+) (DBA(-)DX5(+))) frequencies in pregnant uterus were similar between genotypes. Ly49(KD) lowered the normal frequencies of Ly49(+) uNK cells from 90.3% to 47.8% in DBA(-)DX5(+) and 78.8% to 6.3% in DBA(+)DX5(-) uNK cell subtypes. B6.Ly49(KD) matings frequently resulted in expanded blastocysts that did not implant (subfertility). B6.Ly49(KD) mice that established pregnancy had gestational lengths and litter sizes similar to controls. B6.Ly49(KD) neonates, however, were heavier than controls. B6.Ly49(KD) implantation sites lagged in early (gd6.5) decidual angiogenesis and were deficient in mid-pregnancy (gd10.5) spiral arterial remodelling. Ultrastructural analyses revealed that B6.Ly49(KD) uNK cells had impaired granulogenesis, while immunocytochemistry revealed deficient vascular endothelial cell growth factor (VEGFA) production. Perforin and IFNG expression were normal in B6.Ly49(KD) uNK cells. Thus, in normal mouse pregnancies, Ly49 receptor signaling must promote implantation, early decidual angiogenesis and mid-pregnancy vascular remodelling. Disturbances in these functions may underlie the reported genetic associations between human pregnancy complications and the inability of specific conceptus MHCs to engage activating KIR on uNK cells.

Natural killer cells and regulatory T cells in early pregnancy loss

Survival of the allogeneic embryo in the uterus depends on the maintenance of immune tolerance at the maternal-fetal interface. The pregnant uterus is replete with activated maternal immune cells. How this immune tolerance is acquired and maintained has been a topic of intense investigation. The key immune cells that predominantly populate the pregnant uterus are natural killer (NK) cells. In normal pregnancy, these cells are not killers, but rather provide a microenvironment that is pregnancy compatible and supports healthy placentation. In placental mammals, an array of highly orchestrated immune elements to support successful pregnancy outcome has been incorporated. This includes active cooperation between maternal immune cells, particularly NK cells, and trophoblast cells. This intricate process is required for placentation, immune regulation and to remodel the blood supply to the fetus. During the past decade, various types of maternal immune cells have been thought to be involved in cross-talk with trophoblasts and in programming immune tolerance. Regulatory T cells (Tregs) have attracted a great deal of attention in promoting implantation and immune tolerance beyond implantation. However, what has not been fully addressed is how this immune-trophoblast axis breaks down during adverse pregnancy outcomes, particularly early pregnancy loss, and in response to unscheduled inflammation. Intense research efforts have begun to shed light on the roles of NK cells and Tregs in early pregnancy loss, although much remains to be unraveled in order to fully characterize the mechanisms underlying their detrimental activity. An increased understanding of host-environment interactions that lead to the cytotoxic phenotype of these otherwise pregnancy compatible maternal immune cells is important for prediction, prevention and treatment of pregnancy maladies, particularly recurrent pregnancy loss. In this review, we discuss relevant information from experimental and human models that may explain the pregnancy disrupting roles of these pivotal sentinel cells at the maternal-fetal interface.

Uterine natural killer cells: a specialized differentiation regulated by ovarian hormones

In adult females of many species, a transient population of natural killer (NK) cells appears in cycles within the uterine endometrium (lining). Appearance of these lymphocytes coincides with specific phases of the ovarian hormone cycle and/or early pregnancy. Studies in rodents, women, and pigs dominate the literature and suggest the uterine (u)NK cells are an activated subset sharing many but not all features with circulating or lymphoid organ-residing NK cells. During successful murine pregnancy, uNK cells appear to regulate initiation of structural changes in the feed arterial systems that support maternal endometrial tissue at sites of implantation and subsequent placental development. These changes, which reverse after pregnancy, create a higher volume arterial bed with flaccid vessels unresponsive to vasoactive compounds. These unique pregnancy-associated arterial changes elevate the volume of low-pressure, nutrient-rich, maternal arterial blood available to conceptuses. Regulation of the differentiation, activation, and functions of uNK cells is only partially known, and there is lively debate regarding whether and how uNK cells participate in infertility or spontaneous abortion. This review highlights the biology of uNK cells during successful pregnancy.

Effect of the conceptus on uterine natural killer cell numbers and function in the mouse uterus during decidualization

Uterine natural killer (uNK) cells are the most abundant lymphocytes in the uterus during early pregnancy and play a role in spiral arteriole modifications. In the present study, we investigated whether uNK cell populations differed between mouse decidua and deciduoma. Histochemical staining using the Dolichos biflorus agglutinin (DBA) lectin was used to identify uNK cells and classify their stages of maturation. We found differences in the pattern of localization and density of uNK cells between the decidua and deciduoma at Days 2-4 after the onset of decidualization. The cells were more distributed and the densities were significantly greater in the mesometrial region of the decidua than in the deciduoma. Using double-labeling for DBA lectin binding and bromodeoxyuridine incorporation, we found that the higher number of uNK cells in the decidua was not due to an increase in uNK cell proliferation. Western blot analyses revealed that the increase in uNK cell number was accompanied by significant increases in the levels of interferon gamma (IFNG) and prointerleukin 18 when a conceptus was present. Vascular morphometry revealed that modifications of the spiral arterioles occurred in the mesometrial decidua but not in the deciduoma, which could be attributed to the differences observed in uNK cell number and IFNG production. The present study demonstrates that differences exist in uNK cell populations between the decidua and deciduoma, providing evidence that the conceptus generates signals that regulate uNK cell number and function in the uterus during implantation.

Granulated metrial gland cells in the murine uterus: localization, kinetics, and the functional role in angiogenesis during pregnancy

Granulated metrial gland (GMG) cells are a major immune cell population in the murine pregnant uterus, and contribute to the maintenance of pregnancy by functioning as uterus-specific natural killer (NK) cells. In order to reveal their kinetics, activation, and functional roles in pregnancy, we conducted quantitative and immunohistochemical analyses in normal and immuno-modulator-treated mice. Under a light microscope, GMG cells were identified by red cytoplasmic granules in periodic-acid-Schiff (PAS)-stained sections. They progressively increased in number and size with the peak at day 12-14 of pregnancy in the decidua and metrial gland. New vessel formation was most prominent around day 8, and the total vascular area reached the peak at day 13. GMG cells were often located near the blood vessels, and expressed vascular endothelial growth factor (VEGF), suggesting their possible inducing role in angiogenesis during the development of decidua/metrial gland. While blood vessels in the non-pregnant uterus were negative for vascular cell adhesion molecule (VCAM)-1, those in the pregnant one were positive. Treatment with neutralizing antibody against VCAM-1, however, did not decrease the number of GMG cells. On the other hand, mitosis of GMG cells was frequently observed. These data suggest that the increment of GMG cells during pregnancy may largely result from local proliferation in the uterus rather than an increased influx of precursor cells. Although we attempted to induce in vivo activation of GMG cells by administration of interleukin-12 (IL-12) or alpha-galactosylceramide, a potent activator for natural killer-T (NK-T) cells, the number of GMG cells did not appreciably increase. The present study has demonstrated that GMG cells locally proliferate in the pregnant uterus, not being related to VCAM-1 expression by the uterine vasculature or systemic activation of NK cells and NK-T cells, and seem to be involved in angiogenesis in the pregnant uterus through VEGF production.

Evaluation of natural killer cell recruitment to embryonic attachment sites during early porcine pregnancy

Specialized natural killer (NK) lymphocytes are a feature of the pregnant uterus in humans and rodents. Conceptus-mediated recruitment of uterine (u)NK cells in the pig was proposed based on evidence that elevated uNK activity was temporally associated with increased leukocyte density in endometrium underlying conceptuses. The objective of this study was to determine whether uNK cells were more abundant at embryonic attachment sites during the early postattachment period. Mononuclear leukocytes were isolated from endometrium at attachment sites versus between attachment sites, and expression of CD16, a marker for NK cells, was assessed by flow cytometry. CD16 binding was normalized to leukocyte numbers in each sample. CD16+ small lymphocytes were more frequent in uterus than in blood (41% +/- 2% versus 26% +/- 4%). Differences between pregnant and luteal phase uterus (43% +/- 2% versus 31% +/- 7%, respectively) were not statistically significant. In pregnant animals, CD16+ lymphocytes were slightly but significantly more abundant in uterus at attachment sites versus between attachment sites at Days 15-17, 21-22, and 25-28. Before normalization, CD16+ large, granular cells were more abundant at attachment sites versus between attachment sites; however, these differences were removed when data were normalized according to leukocyte numbers. Further characterization showed that the proportion of large granular leukocytes expressing CD8, reactive with NK cells and T cell subsets, was 2-fold higher in pregnant uterus than in maternal blood. These results raise the possibility that uNK cells resembling those in blood may be transformed into larger, more granulated forms in the uterine microenvironment.

Uterine natural killer cells are targets for a trophoblast cell-specific cytokine, prolactin-like protein A

PRL-like protein A (PLP-A) is a member of the PRL family expressed in trophoblast cells coincident with establishment of the chorioallantoic placenta. The purpose of this investigation was to identify targets for PLP-A. Using an alkaline phosphatase-tagging strategy, we show that PLP-A specifically interacts with a population of natural killer (NK) lymphocytes within the mesometrial compartment of decidua from pregnant and pseudopregnant rats. These observations are supported by the codistribution of PLP-A targets with cells expressing the rat NK cell surface marker, gp42, the absence of PLP-A binding in conceptuses from NK cell-deficient tg epsilon26 mice, and the specific interaction of PLP-A with a rat NK cell line, RNK-16. We have further demonstrated that PLP-A effectively suppresses RNK-16 cell cytolytic activities. Our results provide evidence for a new paradigm of embryonic-maternal communication involving a PLP-A signaling pathway between trophoblast cells and uterine NK lymphocytes.

Kinetics of infection and effects on placental cell populations in a murine model of Chlamydia psittaci-induced abortion

The anatomical progression of chlamydial infection was studied in different areas of the placenta, using a mouse model and two inoculation times: early pregnancy (day 7, group A) and midpregnancy (day 11, group B). The first population cells affected were decidual cells and neutrophils located just at the limits of the maternal and fetal placenta. The following invaded area was the layer of giant cells. Complete colonization of the maternal placenta occurred after day 15 of pregnancy independently of the inoculation time, the metrial gland being the last area to be invaded; numerous granulated metrial gland (GMG) cells were infected. Finally, chlamydial inclusions were observed in labyrinthine trophoblastic cells from day 18 of pregnancy onward. Since no fetal damage was observed, it seems that an indirect mechanism involving the lysis of GMG cells and neutrophil infiltration of the decidua and metrial gland may be the pathogenic mechanism that leads to abortion.

Engraftment of bone marrow from severe combined immunodeficient (SCID) mice reverses the reproductive deficits in natural killer cell-deficient tg epsilon 26 mice

A large, transient population of natural killer (NK) cells appears in the murine uterine mesometrial triangle during pregnancy. Depletion of uterine (u) NK cells, recently achieved using gene-ablated and transgenic mice, results in pathology. Pregnancies from matings of homozygous NK and T cell-deficient tg epsilon 26 mice have <1% of normal uNK cell frequency, no development of an implantation site-associated metrial gland, and an edematous decidua with vascular pathology that includes abnormally high vessel walls/lumens ratios. Fetal loss of 64% occurs midgestation and placentae are small. None of these features are seen in pregnant T cell-deficient mice. To confirm the role of the NK cell deficiency in these reproductive deficits, transplantation of tg epsilon 26 females was undertaken using bone marrow from B and T cell-deficient scid/scid donors. Engrafted pregnant females have restoration of the uNK cell population, induced metrial gland differentiation, reduced anomalies in the decidua and decidual blood vessels, increased placental sizes, and restoration of fetal viability at all gestational days studied (days 10, 12, and 14). Thus, uNK cells appear to have critical functions in pregnancy that promote decidual health, the appropriate vascularization of implantation sites, and placental size.

Perforin-expressing lymphocytes in peripheral blood and decidua of human first-trimester pathological pregnancies

PROBLEM

We have shown previously that the decidua of first-trimester human pregnancy is heavily infiltrated with perforin-positive cells. The aim was to detect expression of perforin in both decidual lymphocytes (DL) and peripheral blood lymphocytes (PBL) in the first trimester of pathological pregnancies: Anembryonic pregnancy and missed abortion.

METHOD

Decidual tissue from a normal pregnancy group and from pathological pregnancies was obtained by vaginal curettage. Perforin (an intracellular antigen) and the cell surface antigens CD3, CD4, CD8, CD16, CD56, CD11c, and CD45RA were quantified simultaneously by flow cytometric analysis.

RESULTS

In the missed abortion group, we found: 1) a relative decrease in the frequency of both CD4+P+ cells and CD56+P+ cells as well as the mean fluorescence intensity for perforin; 2) a relative increase of CD16+P+ PBL cells; and 3) a relative increase of CD4+ cells in PBL compared with anembryonic pregnancy and normal pregnancy. There was also a significant relative decrease in the proportion of CD4+ and CD8+ cells among perforin-positive PBL in both anembryonic pregnancy and missed abortion.

CONCLUSION

Our results show that significant decreases in the prevalence of perforin-positive lymphoid cells, their subpopulations, and mean fluorescence intensity for perforin are associated with pregnancy failure.

The involvement of interleukin (IL)-15 in regulating the differentiation of granulated metrial gland cells in mouse pregnant uterus

Previous studies have suggested that granulated metrial gland (GMG) cells are bone marrow-derived lymphoid cells, which differentiate in situ in the mouse pregnant uterus into natural killer (NK)-like cells. Similar to NK cells, GMG cells express an abundant level of cytolytic mediators such as perforin. The factor(s) regulating the differentiation of GMG cells remain(s) to be identified, although cytokines previously implicated in the stimulation/activation of NK cells (e.g., IL-2, IL-6, IL-7, and IL-12) can be considered as potential candidates. Recently, IL-15, a novel cytokine, which displays biological activities similar to IL-2, has also been shown to be capable of activating NK cells. Using reverse transcription-polymerase chain reaction (RT-PCR) analysis, we have demonstrated in the present study that IL-15 and its cognate receptor, but not the other cytokines, are expressed in the mouse pregnant uterus, with a time course concomitant with those of cytolytic mediators in differentiated GMG cells. Moreover, IL-15, though not IL-2, is capable of inducing the expression of perforin and granzymes in pregnant uterine tissues explanted in vitro. Data obtained from in situ hybridization study have suggested that the macrophages present in the pregnant uterus may be responsible for the production of IL-15. These results suggest that IL-15 is involved in regulating the differentiation of GMG cells during mouse pregnancy.

Murine granulated metrial gland cells are susceptible to Chlamydia psittaci infection in vivo

Granulated metrial gland (GMG) cells are the most numerous lymphoid cells in the uteroplacental unit in rodent pregnancy. In an experimental murine model of abortion-causing infection, we have studied the responses of GMG cells to Chlamydia psittaci. Chlamydial inclusions have been found within GMG cells, both in apparently healthy cells and in cells with degenerative changes. Establishing the existence of GMG cells infected by C. psittaci opens a new and interesting chapter in the study of these cells.

Embryo implantation in mouse: fetomaternal coordination in the pattern of expression of uPA, uPAR, PAI-1 and alpha 2MR/LRP genes

During the process of embryo implantation, trophoblast cells invade deep into uterine stroma and play a key role in establishing fetomaternal exchange of molecules. We have studied the in vivo expression patterns of the molecules of the urokinase system, during the process of mouse embryo implantation and early placentation. The sites of synthesis of urokinase-type plasminogen activator (uPA), uPA-receptor (uPAR), plasminogen activator inhibitor type 1 (PAI-1) and alpha 2-macroglobulin receptor/low density lipoprotein receptor-related protein (alpha 2MR/LRP) transcripts were determined by in situ hybridization. These genes were found to be expressed in a finely regulated pattern. High levels of uPA mRNA were found in invasive trophoblast cells, while the same cells did not appear to synthesize PAI-1. Starting from day 6.5, endothelial cells of newly forming vessels also transcribed uPA gene. uPAR and alpha 2MR/LRP were in all stages expressed by decidual tissue, and their expression domains overlapped in large areas. Immunohistochemistry with uPA and PAI-1 antibodies revealed areas of co-localization of these secreted proteins with the expression domains of uPAR and alpha 2MR/LRP, which is of great interest in view of the role of these two receptors in clearing uPA-PAI-1 complexes. In situ zymography demonstrated the presence of active uPA in the ectoplacental cone region at 7.5 and 8.5 days. Our studies outline the expression of a set of functionally related genes that is well coordinated between fetal and maternal tissues. This coordination may model other physiological and pathological invasive processes.

Characterisation of the morphogenetic course and secretion of two different types of mucoid material by granulated metrial gland/lymphokine-activated killer cells

Lymphocytes from mesenteric lymph nodes of ordinary and nude mice were grown in microtitre wells on embryonic mesenchymal-fibroblast monolayers. Human recombinant interleukin-2 (80 units ml-1) was added. Clones of lymphokine-activated killer (LAK) cells developed. The incidence of clone-forming cells was 52-136 per 10(5) cells in lymph nodes from nude mice and 4.2-8.3 per 10(5) cells in lymph nodes from ordinary mice. On a limited number of fibroblast monolayers propagated in culture, the maturing LAK cells were induced to synthesise and secrete 2 types of flowing mucoid material. After methanol fixation and Alcian blue/periodic acid-Schiff (PAS) (at pH 1) staining, the first type of material was distinctively stained turquoise, indicating a highly sulphated proteoglycan, chondroitin sulphate; the second type of material, a macromolecular neutral polysaccharide, was not stained and appeared to have been dissolved. Glycogen was stained deep brilliant purple. After treatment with PAS alone, the chondroitin sulphate was not stained and appeared as a bright area, the neutral polysaccharide mass being stained deep red. This polysaccharide material was characteristically secreted as droplets or 'streamlets' emerging from the cell surface and extending through the first type of material to coalesce with the already accumulated main extracellular mucoid layer spreading between the cells. Clones of secretory LAK cells were obtained from gravid and nongravid mouse uteri as well as from tracheal explants. Change of medium or passage with fresh medium to a new inducing batch of monolayer, at the blastoid-large granular lymphocyte stage (on d 3 to 7), was critical for high reproducibility of secretion. The course of differentiation was found ultimately to be dependent on the embryonic mesenchymal monolayer, suggesting induction by a morphogenetic signal. A correlation can be drawn between the secretory activity and the morphological profile at maturation of highly distinctive organised cells.

Synthesis and granular localization of tumor necrosis factor-alpha in activated NK cells in the pregnant mouse uterus

The synthesis and cellular localization of tumor necrosis factor-alpha (TNF-alpha) were studied in mouse GMG cells, which are activated NK cells in uterine decidual tissue during pregnancy. Synthesis of the protein was demonstrated in GMG cells on days 10 and 14 of pregnancy by in situ hybridization of TNF-alpha message. Immunostaining demonstrated that TNF-alpha protein was localized in the cytoplasmic granules of GMG cells at these times. The results suggest that the cytolytic activity of uterine NK cells may be due in part to TNF-alpha, and that this cytokine may be delivered to target cells intracellularly via transmembrane pores formed by perforin, which is also localized in uterine NK cell granules.

Distribution of perforin-containing cells in normal and pregnant mice

Cytotoxic T lymphocytes (CTL) and natural killer (NK) cells elaborate a cytolytic protein named perforin or cytolysin. It was widely held that, in vivo, high quantities of perforin are not present in resting lymphocytes and are usually produced only by activated lymphocytes found under pathological conditions. Until now, only one tissue was known to synthesize abundant quantities of perforin under nonpathological conditions, the uterus during pregnancy. To investigate the possibility that perforin might also be synthesized by other tissues, several tissues besides the uterus from pregnant and normal mice were tested by immunofluorescence and immunoperoxidase for the presence of perforin. The tissues studied were the ears, brain, nasal epithelium, tongue, salivary gland, larynx, thymus, stomach, liver, spleen, small intestine, and lymph nodes; two cell populations with different sizes and levels of perforin expression were found. Large cells, displaying the NK cell phenotype and expressing high levels of perforin, were detected not only in the uterus but also in the salivary gland and lungs of pregnant mice. Small cells, expressing low levels of perforin, were detected mainly in the stomach and small intestine, and they were expressed in both pregnant and normal mice. Taken together, these results imply that perforin-containing cells exist in vivo under nonpathological conditions, and that the immune system is endowed with heretofore unknown mechanisms for stimulating the activation of NK cells in a limited number of tissues during pregnancy.

Granulated metrial gland cells: a natural killer cell subset of the pregnant murine uterus

The metrial gland develops in the uterus of many rodent species during normal pregnancy. It is a maternally-derived tissue that contains stromal and vascular elements plus a population of large cells, striking in their light microscopic appearance due to the presence of numerous cytoplasmic granules. These cells, which have become known in mice and rats as granulated metrial gland (GMG) cells, are derived from bone marrow precursors and recent work suggests they are a subset of lymphocytes belonging to the natural killer (NK) cell lineage. The functions of GMG cells during normal gestation have not been clearly defined. In vitro, GMG cells have been shown to produce cytokines and their cytokine profile is altered upon addition of medium containing the T cell growth factor interleukin-2 (IL-2). GMG cell granules contain the cytolytic protein perforin but GMG cells have a very limited capacity to kill in vitro unless they have been stimulated by IL-2 or interferon-gamma. Histological study of GMG cells has suggested they preferentially associate with fetal trophoblast. Since trophoblast appears resistant to immune lysis, except by IL-2-activated effector lymphocytes, and because resorbing murine embryos become infiltrated by lytic cells of the NK cell lineage, it is important to establish whether GMG cells are activated by pregnancy-associated events to play a major lytic role in vivo.