Preeclampsia: Immunologic alteration of Nitabuch's membrane? Clinical sequelae

Objective To determine if preeclampsia is an immunologic disease process consistent with a host‐vs.‐graft reaction by examining differences in immunoglobulin deposition at the maternal‐fetal interface (Nitabuch's layer) in preeclamptic patients. Study design: A prospective study of patients at...

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Bibliographic Details
Published in:The Journal of maternal-fetal medicine 1997-11, Vol.6 (6), p.324-328
Main Authors: Balducci, James, Weiss, Patrice M., Atlas, Robert O., Pajarillo, Marc F., Dupree, William B., Klasko, Stephen K.
Format: Article
Language:English
Subjects:
Cohort Studies
Extraembryonic Membranes
Female
Fluorescent Antibody Technique, Indirect
Humans
Immunoglobulin A - analysis
Immunoglobulin G - analysis
Immunoglobulin M - analysis
Nitabuch's membrane
placenta
Placenta - immunology
Placenta - pathology
Pre-Eclampsia - immunology
Pre-Eclampsia - pathology
preeclampsia
Pregnancy
Prospective Studies
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Summary:Objective To determine if preeclampsia is an immunologic disease process consistent with a host‐vs.‐graft reaction by examining differences in immunoglobulin deposition at the maternal‐fetal interface (Nitabuch's layer) in preeclamptic patients. Study design: A prospective study of patients at Lehigh Valley Hospital was conducted between July 1993 and April 1994. Group 1 (study) consisted of 11 primigravid women meeting the criteria for the diagnosis of preeclampsia. Group 2 (control) consisted of 11 primigravid women who had an uncomplicated pregnancy. At delivery, basal plate placental specimens were obtained, fixed, and processed for study by a blinded observer utilizing IgG, IgA, IgM, IgE immunofluorescence techniques. The placenta was then sent to a gynecologic pathologist for blinded evaluation and measurement of Nitabuch's membrane by light microscopy. Results Taking the average width of 3 measurements of Nitabuch's membrane by light microscopy revealed no significant difference (group 1, .1839 mm vs. group 2, .1555 mm). Immunofluorescence techniques revealed that the thickness of immunofluorescence of Nitabuch's membrane was significantly greater in the study group vs. the control group (157.48 pixels vs. 63.80 pixels, P = .006, respectively). Conclusion Evaluation of the maternal‐fetal interface reveals the deposition of increased immunoglobulins, the physiology of which may be similar to nephropathies as seen in systemic disease processes. The deposition of immunoglobulins may be associated with a common antigen which may point to an immunologic etiology for preeclampsia in some women. J. Matern.‐Fetal Med. 6:324–328, 1997. © 1997 Wiley‐Liss, Inc.
ISSN:1057-0802
1520-6661
DOI:10.1002/(SICI)1520-6661(199711/12)6:6<324::AID-MFM5>3.0.CO;2-Q