Might wasp venom desensitization induced Th2 to Th1 shift cause pregnancy failure?
The case of a 28-year-old woman under wasp venom desensitization having a premature birth in her 24th week of pregnancy 16 days after the last injection is described. To test the hypothesis that a special profile of immune cells in the decidua may trigger abortions, placental and decidual tissue sections were stained with antibodies against T cells (CD3), cytotoxic cells (CD8), natural killer cells (CD56), and mast cells, and an in-situ-hybridization was performed for tumor necrosis factor-alpha (TNF-alpha). CD56+ Natural killer cells were the dominating population. In earlier analyses of healthy first trimester decidua the percentage of NK cells and T cells was in a similar range, but the CD8:CD3 ratio was only 2.2% in contrast to 27% in the present case. Mast cells, which are known to be able to secrete abortogenic TNF-alpha, were only detectable in the decidua (10 cells/mm2) and decidua sections were TNF-alpha positive. Since SIT induces a shift of the interleukin and functional profile from a Th2 type towards a Th1 type, and pregnancy is dependent on a Th2 pronounced profile, SIT may trigger abortions or immature births. This is supported by the present results and might have happened in this case.
Markert
Udo R
UR
Department of Obstetrics, Friedrich Schiller University, Jena, Germany. udo.markert@med.uni-jena.de
Arck
Petra C
PC
Peiker
Gertrud
G
Mock
Bettina A
BA
D000022:Abortion, Spontaneous / Q000209:etiology* / Q000276:immunology*; D000328:Adult; D000818:Animals; D000075202:Contraindications; D003656:Decidua / Q000276:immunology; D003888:Desensitization, Immunologic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D018448:Models, Immunological; D010920:Placenta / Q000276:immunology; D011247:Pregnancy; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D014862:Wasp Venoms / Q000008:administration & dosage / Q000009:adverse effects*
D014862:Wasp Venoms