Expression of dNK cells and their cytokines in twin pregnancies with preeclampsia

OBJECTIVES: To assess the expression of decidual natural killer (dNK) cells and their cytokines in twin pregnancies with preeclampsia. METHODS: This was a prospective case-control study. The inclusion criteria were diamniotic (monochorionic or dichorionic) twin pregnancies in the third trimester with negative serological results for infectious diseases; absence of major fetal abnormalities or twin-twin transfusion syndrome; and no history of administration of corticosteroids in this pregnancy. The control group (CG) included uncomplicated twin pregnancies, and the preeclampsia group (PEG) included twin gestations with clinical and laboratory confirmation of the disease according to well-established criteria. Samples of the decidua were obtained and analyzed by immunohistochemistry for the expression of dNK cells and interleukins (ILs) 10, 12 and 15. In addition, maternal serum samples were collected to determine the levels of these interleukins. RESULTS: Thirty twin pregnancies were selected: 20 in the control group (CG) and 10 in the preeclampsia group (PEG). The PEG showed strong placental immunostaining for IL-15 (p=0.001) and high maternal serum levels of IL-10 (22.7 vs. 11.9 pg/mL, p=0.024) and IL-15 (15.9 vs. 7.4 pg/mL, p=0.024). CONCLUSION: A higher maternal serum concentration of both pro- and anti-inflammatory factors was observed in the twin pregnancies in the PEG. However, no difference in placental expression of IL-10 was found between the groups. These findings may suggest that maternal attempts to balance these interleukins were not sufficient to cause a placental response, and this failure may contribute to the development of preeclampsia.

Utilização de técnicas de reprodução assistida e resultados perinatais / Use of assisted reproduction technologies and perinatal outcome

Nos ultimos anos, cada vez mais se tem difundido as técnicas de reprodução assistida e seu uso. A sua relação com malformações fetais e outras alterações em crianças geradas por estas técnicas têm sido objeto de grande discussão. Através da análise da literatura dos últimos 15 anos foi possível observar que os estudos parecem demonstrar um aumento da frequência de malformações urinárias em meninos concebidos por TRA e novos pontos de discussão têm sido levantados como risco de neoplasias, defeitos de imprinting gênico, alterações do desenvolvimento neuropsicomotor e até questionamentos com relação à fertilidade futura destas crianças. São necessários ainda novos estudos abrangendo casuísticas mais extensas e um seguimento a médio e longo prazo destas crianças.