Prevalence of CD138+ uterine plasma cells and CD56-positive uterine NK-cells in patients with recurrent miscarriage

K Vomstein; RJ Kuon; M Weber; U Markert; T Strowitzki; B Toth

doi:10.1055/s-0038-1671287

Geburtshilfe und Frauenheilkunde, Table of Contents

Geburtshilfe Frauenheilkd 2018; 78(10): 177
DOI: 10.1055/s-0038-1671287

Poster

Freitag, 02.11.2018

Endokrinologie und Reproduktionsmedizin II

Georg Thieme Verlag KG Stuttgart · New York

Prevalence of CD138+ uterine plasma cells and CD56-positive uterine NK-cells in patients with recurrent miscarriage

Authors

K Vomstein

¹Medizinische Universität Innsbruck, Gynäkologische Endokrinologie und Reproduktionsmedizin, Innsbruck, Österreich

²Universitärtsklinikum Heidelberg, Gynäkologische Endokrinologie und Fertilitätsstörungen, Heidelberg, Deutschland
RJ Kuon

²Universitärtsklinikum Heidelberg, Gynäkologische Endokrinologie und Fertilitätsstörungen, Heidelberg, Deutschland
M Weber

³Universitätsklinikum Jena, Klinik für Geburtsmedizin, Plazentalabor, Jena, Deutschland
U Markert

³Universitätsklinikum Jena, Klinik für Geburtsmedizin, Plazentalabor, Jena, Deutschland
T Strowitzki

²Universitärtsklinikum Heidelberg, Gynäkologische Endokrinologie und Fertilitätsstörungen, Heidelberg, Deutschland
B Toth

¹Medizinische Universität Innsbruck, Gynäkologische Endokrinologie und Reproduktionsmedizin, Innsbruck, Österreich

Abstract

Full Text

Objective:

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.

Methods:

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.

Results:

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).

Conclusion:

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.