Women with recurrent spontaneous abortion have decreased 25(OH) vitamin D and VDR at the fetal-maternal interface

Immunological mechanisms have been proposed to underlie the pathogenesis of recurrent spontaneous abortion (RSA). Vitamin D has a potent immunomodulatory effect, which may affect pregnancy outcome. The objective of this study was to investigate 25-hydroxyvitamin D [25(OH) D] concentration and vitamin D receptor (VDR) expression in the decidual tissues of RSA patients. Thirty women with RSA (RSA group) and thirty women undergoing elective abortion (control group) were recruited during 2016 from gynecology outpatient clinics. We measured 25(OH) D, interleukin (IL)-17, IL-23, transforming growth factor β (TGF-β), VDR and 1-α-hydroxylase (CYP27B1) in decidual tissues collected during the abortion procedure. In the RSA group, 25(OH) D and TGF-β were significantly decreased while IL-17 and IL-23 were significantly increased compared with the control group. VDR expression was significantly decreased in the RSA group compared with the control group. Logistic regression analysis showed a significant negative correlation between 25(OH) D in decidual tissues and RSA. These results indicated that vitamin D concentrations in the decidua are associated with inflammatory cytokine production, suggesting that vitamin D and VDR may play a role in the etiology of RSA.

Early pregnancy decidua as a source of TGFB

Several studies have shown that decidual tissue produces soluble factors which can regulate a variety of immunosuppressive activities, but the cell type and the molecule responsible is not clearly defined. This study was performed in order to assess 1] whether active Transforming Growth Factor Beta [TGF beta] was present in decidual supernatants produced by explants, cell suspensions and endometrial granulated lymphocytes [eGL] [CD56+CD16-CD3-], and 2] define whether eGL acts as a major decidual suppressor cell for production of TGF beta in early pregnancy decidua. TGF beta assay was applied using TGF beta -sensitive CCL-64 mink lung epithelial cell line [Mv/Lu]. The supernatants from 10 human specimens of early pregnancy decidua were used in the assay in their native state, after acidification and after treatment with anti-TGF beta. The present study showed that decidual supernatants contain both TGF beta activity in which eGL CD56-positive cells have an important role in production of this suppressor factor. Studies of TGF beta activity in pathological pregnancy may be worthwhile to elucidate whether this molecule is critical for survival of the fetoplacental unit