Evaluation expression of the immune checkpoint inhibitory factors in women with preeclampsia compared with healthy pregnant women

Abstract

Preeclampsia (PE) is a severe complication in pregnancy, and its symptoms (proteinuria and hypertension) manifest around week twenty of gestation, affecting up to 8% of pregnancies. PE not only raises the morbidity and death rate of both pregnant mothers and fetuses but also may cause long-term problems. Number of factors are involved in PE pathogenesis such as inappropriate placentation, insufficient trophoblast invasion and maladaptation of the maternal immune system. The pregnant women's immune system uses different tolerance mechanisms to deal with a semi-allogeneic fetus. The T-cell subsets including CD8+, CD4+, and Treg play a critical role in maintaining pregnancies. The expression of immune checkpoint molecules in T-cells can ensure pregnancy at the feto-maternal interface by controlling immune responses. This research aims to evaluate the expression level of immune checkpoint factors, including PD-1, LAG-3, CTLA-4, and TIM-3 in normal pregnant women and PE patients. Material and method: Decidual tissue was collected from 50 participants (25 PE and 25 control). For evaluating the genes expression, real-time PCR was employed. The western blot was used to assess the proteins level. Results: The results of real-time PCR indicated significantly decreased expression level of these immune checkpoints in PE patients. In parallel to gene expression results, the protein level of PD-1, LAG-3, CTLA-4, and TIM-3in the PE group was also reduced.