etd Ege Tıp Dergisi 1016-9113 2147-6500 Ege Üniversitesi 10.19161/etd.551214 Health Care Administration Sağlık Kurumları Yönetimi An immunohistochemical staining study for comparison of the T lymphocyte subgroups and the uterine natural killer cells in the decidua from spontaneous abortions and voluntary pregnancy terminations Spontan abortus ve istemli gebelik tahliyesi olgularında desiduada T lenfosit subgrupları ve uterin doğal öldürücü hücre sayılarının immunohistokimyasal yöntem ile karşılaştırılması https://orcid.org/0000-0001-7621-7503 Köse Semir Buca Kadın Doğum ve Çocuk Hastalıkları Hastanesi, Perinatoloji, İzmir https://orcid.org/0000-0002-3185-0505 Karaarslan Takmaz Serap Ege Üniversitesi Tıp Fakültesi, Patoloji AD, İzmir https://orcid.org/0000-0002-1728-4797 Ulukuş Murat 2 Ege Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum AD, İzmir https://orcid.org/0000-0001-9728-4385 Zekioğlu Osman Ege Üniversitesi Tıp Fakültesi, Patoloji AD, İzmir https://orcid.org/0000-0002-7513-7285 Yılmaz Hüseyin Ege Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum AD, İzmir 06 28 2019 58 2 170 177 09 15 2018 11 21 2018 Copyright © 1962, Ege Tıp Dergisi 1962 Ege Tıp Dergisi

Aim: To investigate the role ofthe decidual total T lymphocyte count, T cytotoxic (Tc) and T helper (Th)sub-populations and the uterin natural killer (uNK) cells in the pathogenesisof the spontaneous abortions (SA) and recurrent pregnancy loss (RPL) cases.Materials and Methods: Weincluded the SA (n:29) and the voluntary pregnancy termination (n:10) caseswhich were undergone suction curettage between January 2003-January 2005 at theEge University Obstetrics and Gynecology Department and their paraffin blockswere obtained.Results: Median CD3+ T lymphocytecell counts were not different between the control (314; 210-489), incompleteabortions (560;183-1602) and missed abortions (426;154-1102) groups (p:0.117).Median CD4+ Th cell counts were not different between the control (143;87-203), incomplete abortions (236;77-735) and missed abortions (236;76-677)groups (p:0.441). Median CD8+ Ts cell counts were not different between thecontrol (179; 105-279), incomplete abortions (239;90-820) and missed abortions(197;84-560) groups (p:0.530). Median CD56+ uNK cell counts were not differentbetween the control (634; 554-1390), incomplete abortions (714;653-2165) andmissed abortions (712;306-2108) groups (p:0.099).Conclusion: Abortions and RPL are heterogeneous groups consisting of casesrepresenting various pathogenetic origins. Aberrant immune mechanisms could beresponsible for a subgroup if not in all cases. Further studies designed byclassifying the cases karyotypically and utilizing more sophisticated methods(such as flow cytometry, gene expression and receptor activation analyses) areneeded to elucidate the complicated role of the immune system elements in thespontaneous abortion cases.

Amaç: Desiduada T lenfositlerintoplam sayılarının, sitotoksik (Ts) ve helper (Th) alt gruplarının ve uterin naturelkiller (uNK) hücre sayılarının abortuslar ve tekrarlayan gebelik kayıplarının(TGK) patogenezindeki rolünün araştırılması hedeflenmiştir.Gereç ve Yöntem: Ocak 2003- Ocak 2005tarihleri arasında Ege Üniversitesi Kadın Hastalıkları ve Doğum kliniğindegebelik tahliyesi yapılmış ve küretaj materyallerine ait parafin blokları eldeedilen abortus (n:29) ve sağlıklı kontrol olarak isteğe bağlı gebeliktahliyeleri (n:10) olguları çalışmaya dahil edildi. Tüm T lenfositler içinortak belirteç CD3, Th için CD4, Ts için CD8 ve uNK hücreleri için CD56belirteçleri ile seçici immunohistokimyasal boyama sağlandı ve her preparatiçin 10 alanda hücreler sayıldı.Bulgular: Medyan CD3+ T lenfosittoplam hücre sayıları kontrol grubunda 314 (210-489), inkomplet abortusgrubunda 560 (183-1602) ve missed abortus grubunda ise 426 (154-1102) idi (p:0.117). Medyan CD4+ Th hücre sayıları kontrol grubunda 143 (87-203), inkompletabortus grubunda 236 (77-735) ve missed abortus grubunda ise 236 (76-677) idi(p: 0.441). Medyan CD8+ Ts hücre sayıları kontrol grubunda 179 (105-279),inkomplet abortus grubunda 239 (90-820) ve missed abortus grubunda 197 (84-560)idi (p:0.530). Medyan CD56+ uNK hücre sayıları kontrol grubunda 634 (554-1390),inkomplet abortus grubunda 714 (653-2165) ve missed abortus grubunda 712(306-2108) idi (p:0.099).Sonuç: Abortuslar ve TGK heterojengruplardır ve farklı patogeneze sahip olgulardan oluşmaktadır. Bir alt gruptaimmün mekanizmalar nedensel rol oynuyor olabilir. Öncelikle karyotip analiziile kategorize edilmiş gruplarda daha güncel metodlarla (akış sitometri, genekspresyon ve reseptör aktivasyon analizleri) yapılacak ileri çalışmalarabortuslarda immün sistem elemanlarının karmaşık rolünün aydınlatılması içingerekli görünmektedir.

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