Prevalence of CD138+ uterine plasma cells and CD56-positive uterine NK-cells in patients with recurrent miscarriage
20 September 2018 (online)
Chronic endometritis (CE) has been associated with recurrent miscarriage (RM). However diagnosis and treatment are challenging. Detection of Syndecan-1 (CD138+) endometrial plasma cells by immunohistochemistry provides an accurate diagnosis of CE. The aim of this study is to analyse the prevalence of CD138+ endometrial plasma cells as well as the correlation to uterine natural killer (uNK) cell numbers in RM patients. In addition, persistence of CE after antibiotic treatment is evaluated.
In n = 125 non-pregnant patients with ≥3 consecutive miscarriages an endometrial biopsy was performed in the mid-luteal phase. CD138+ endometrial plasma cells and CD56+ uNK cells were analysed by immunohistochemistry. Patients with increased CD138+ plasma cell levels (> 5/mm2) were treated with doxycycline (200 mg for the first day and 100 mg/d for 20 days). To evaluate the persistence of CE, a second biopsy was performed during the next menstrual cycle and CD138+ cells were analysed.
The prevalence of CE in RM patients was 9.6% (12/125) with 4 RM patients showing 5 – 10 CD138+ plasma cells/mm2 and 8 patients with > 10 CD138+ plasma cells/mm2. There was no correlation between CD56+ uNK and CD138+ endometrial plasma cell numbers (p = 0.68). All RM patients (n = 12) diagnosed with CE received antibiotic treatment. Only 8% of RM patients showed persistent presence of CD138+ plasma cells (< 5 mm2).
In our cohort of RM patients the prevalence of CE was 9.6%. Further studies will focus on life birth rates in such patients in order to establish CE as a new risk factor in RM.