Christopher Robinson: Immune Tolerance Breakdown in Pregnancy and Parallels with Transplant Rejection
Christopher Robinson, Associate Professor Maternal Fetal Medicine at University of South Carolina, shared a post on LinkedIn about a paper by Pierre Hannoun et al. published in AJOG:
“AJOG Expert Review: Immune tolerance breakdown in pregnancy: transplantation parallels in chronic intervillositis and villitis of unknown etiology – Rejection parallels in kidney allografts and placental lesions
This figure illustrates the histopathological parallels between allograft rejection in kidney transplantation (top row) and chronic inflammatory lesions of the placenta (bottom row), supporting the concept of immune rejection at the maternal-fetal interface. Panel A: representative features of kidney allograft rejection. Antibody-mediated rejection (AMR) is characterized by microcirculatory inflammation, deposition of complement component C4d, and glomerular capillaritis.
T cell-mediated rejection (TCMR) displays interstitial inflammation and tubulitis. Panel B: representative features of placental lesions. Chronic histiocytic intervillositis (CHI), considered a potential AMR-equivalent, exhibits maternal intervillous infiltration, CD68+ macrophage accumulation, and C4d deposition on the syncytiotrophoblast and fetal vessels.
Villitis of unknown etiology (VUE), reflecting a TCMR-like pattern, is defined by lymphocytic infiltration of chorionic villi with CD8+ predominance and structural villous damage. These parallels reinforce the analogy between allograft rejection and placental inflammatory disorders and support the immunopathological framework proposed in this review.”
Title: Immune tolerance breakdown in pregnancy: transplantation parallels in chronic intervillositis and villitis of unknown etiology
Authors: Pierre Hannoun, Alexandra Benachi, Marion Rabant, Cédric Usureau, Jean-Luc Taupin, Julien Zuber
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