Geburtshilfe Frauenheilkd 2016; 76 - P217
DOI: 10.1055/s-0036-1592766

Immunohistochemical analysis of CD56-positive uNK-cells in the endometrium

M Weber 1, B Toth 2, I Santillan 3, E Schleußner 4, UR Markert 1
  • 1University Hospital Jena, Department of Obstetrics and Gynecology, Placenta-Lab, Jena, Deutschland
  • 2University Hospital Heidelberg, Gynecological Endocrinology and Fertility Disorders, Heidelberg, Deutschland
  • 3Centro Médico Palencia, Madrid, Spanien
  • 4University Hospital Jena, Department of Obstetrics and Gynecology, Jena, Deutschland

Recurrent miscarriage (RM) and repeated implantation failure (RIF) are highly frustrating reproductive disorders. Uterine natural killer cells (uNK) form a large portion of immunological cells in the uterine cavity and are major players during implantation and early pregnancy. However, the distribution during the menstrual cycle and the pathophysiological significance in (early) pregnancy is only partially understood. Preliminary evidence indicates that the concentration of uNK cells in women with RM and RIF is increased. The aim was to establish an analytic model in order to quantify uNK cell concentration in the endometrium of RM and RIF patients.

Methods: Endometrial biopsies were investigated via immunohistochemistry using DAB – proof of CD56-positive uNK cells.

Results: The endometrium of RIF/RM patients respectively contained 275 ± 202 and 233 ± 185 uNK cells/cm2, with 67.5% (RIF) and 65, 7% (RM) of samples showing an uNK-cell count of 40 – 300 and 30.8% (RIF) and 27.0% (RM) of samples with 300 – 600 (or more) uNK cells/cm2. In contrast, 158 ± 70 uNK cells/cm2 was detected in the controls, of which 93% were within the 40 – 300 range. Significant differences were observed between patients and controls (p < 0.001), but not between case groups (p = 0.763). Based on these and other works we carried out a score for the diagnostic evaluation of uNK cells: 0 – 40 = low, 40 – 300 = normal, 300 – 600 = increased and > 600 = highly increased count.

uNK-cells are increased in 28.7% of RSA/RIF patients and might help to identify RM/RIF patients that benefit from currently investigated immunomodulatory therapies.