Ek. Haddad et al., EARLY EMBRYO LOSS IS ASSOCIATED WITH LOCAL PRODUCTION OF NITRIC-OXIDEBY DECIDUAL MONONUCLEAR-CELLS, The Journal of experimental medicine, 182(4), 1995, pp. 1143-1151
In early embryo loss, the fetus may be considered to be an allograft a
nd, therefore, may be rejected by maternal immunocytes. However, the c
ytotoxic mechanisms involved are still poorly understood. We have prev
iously shown the involvement of natural killer (NK) cells and mononucl
ear cells expressing Mac-1 (CD11b) and F4/80 in resorbing compared to
nonresorbing embryos. In this study, the role of nitric oxide (NO) in
the mechanism of early embryo loss was studied. Pregnant CBA/J females
mated with DBA/2 males (20-30% early embryo loss) and CD1 females mat
ed with CD1 males (5-10% early embryo loss) were studied on days 8, 10
, and 12 of gestation. Cells from the implantation sites of individual
embryos were tested for the production of nitrite and nitrate with or
without in vitro challenge with lipopolysaccharide (LPS) to determine
whether decidual macrophages were primed in situ. On day 12 of gestat
ion, when resorption was clearly visible, resorbing embryos showed mor
e than a fivefold increase in both basal- and LPS-induced nitrite and
nitrate production compared to nonresorbing embryos in both mouse stra
ins tested, indicating that the decidual mononuclear cells were primed
. Furthermore, more than 20% of CBA/J embryos showed a significant nit
rate release on days 8 and 10 of gestation before any signs of embryo
cytopathology. This percentage col-responded to the spontaneous resorp
tion rate seen in CBA/J female X DBA/2 male matings. Similarly, 4% of
the embryos from pregnant CD1 mice on days 8 and 12 of gestation produ
ced a significant amount of nitrate, which again correlated with the l
ow incidence of resorption observed in these mice. Using immunohistoch
emistry, the presence of inducible nitric oxide synthase (iNOS) was de
tected at implantation sites. Furthermore, decidual cells positive for
both iNOS and the macrophage marker Mac-1 were demonstrated in implan
tation sites by double immunostaining. This strongly suggests that dec
idual macrophages could be the cellular source of NO production. Amino
guanidine, a selective inhibitor of the iNOS, inhibited the in vitro p
roduction of nitric oxide by cells isolated from individual implantati
on sites, and more strikingly, significantly reduced early embryo loss
es in CBA/J females mated by DBA/2 males when given orally or parenter
ally to the gravid females starting on day 6 of gestation. In addition
, aminoguanidine-treated pregnant mice showed a significant increase i
n average litter size when the pregnancies were allowed to proceed to
term. The results presented strongly gested a role for NO as an effect
or molecule in mediating early embryo loss and showed the in situ acti
vation of decidual macrophages was an early event preceding spontaneou
s abortion.