title: Stress and immune mediators in miscarriage.
abstract: BACKGROUND
  Stress is thought to be abortogenic and psycho-neuro-immunological pathways have been suggested to be involved in triggering miscarriages. From experiments in pregnant mice exposed to stress some insights into the underlying mechanisms have been gained, delineating immunological imbalances as a cause of pregnancy failure. In order to test the validity of the conclusions drawn from murine experiments and the role of stress in human pregnancy loss, the following study was performed.
  
  
  METHODS
  We used an established perceived stress questionnaire and measured the stress score of women with a confirmed diagnosis of first trimester spontaneous abortion (n = 94). Decidual tissue was investigated by immunohistochemistry and in-situ hybridization to detect the presence and distribution of immunocompetent decidual cells [CD56(+) natural killer (NK) cells, CD8(+)and CD3(+) T cells, tryptase(+) mast cells (MCT(+)) and tumour necrosis factor (TNF)-alpha(+) cells]. The patient cohort was divided into women experiencing low or high levels of stress.
  
  
  RESULTS
  In the decidua of women with high stress scores we observed significantly higher numbers of MCT(+), CD8(+) T cells and TNF-alpha(+) cells per mm(2) tissue (P < or = 0.05). No significant differences between individuals with lower or higher stress scores could be observed with respect to decidual CD56(+) NK and CD3(+) T cells.
  
  
  CONCLUSIONS
  Using a questionnaire to score perceived stress in humans may be a valid approach to assess non-biased stress scores. Stress-triggered abortion in humans, identified by a questionnaire, can be linked to immunological imbalances.
authors: Charité, Campus Virchow Klinik, Biomedical Research Center, Humboldt University, Raum 2.0549, Augustenburger Platz 1, 13353 Berlin, Germany. petra.arck@charite.de
authors: P C
authors: PC
authors: Arck
authors: M
authors: M
authors: Rose
authors: K
authors: K
authors: Hertwig
authors: E
authors: E
authors: Hagen
authors: M
authors: M
authors: Hildebrandt
authors: B F
authors: BF
authors: Klapp
mesh_terms: D000022:Abortion, Spontaneous / Q000276:immunology* / Q000473:pathology; D000328:Adult; D017252:CD3 Complex / Q000032:analysis; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002452:Cell Count; D003656:Decidua / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D007694:Killer Cells, Natural / Q000276:immunology; D008407:Mast Cells / Q000201:enzymology / Q000276:immunology; D011247:Pregnancy; D012697:Serine Endopeptidases / Q000032:analysis; D013315:Stress, Psychological / Q000276:immunology*; D011795:Surveys and Questionnaires; D013601:T-Lymphocytes / Q000276:immunology; D053802:Tryptases; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D017252:CD3 Complex; D014409:Tumor Necrosis Factor-alpha; D012697:Serine Endopeptidases; D053802:Tryptases