Decidual Leukocyte Involvement in Human Spiral Artery Remodeling

The decidualized endometrium harbors abundant leukocyte populations that are proposed to regulate critical processes at the maternal fetal interface including transformation of decidual spiral arteries. The work in this thesis investigated the leukocyte subtypes in the decidua throughout the course of this vascular transformation. A particular focus was the role of the uterine Natural Killer (uNK) cells and macrophages in an in vitro model of vascular remodeling. A significant infiltration of uNK cells and macrophages, matrix metalloproteinase-2/9 activity, and evidence of apoptosis and phagocytosis were observed in remodeling arterioles. From first to second trimester, FACS analysis demonstrated dramatic changes in the decidual leukocyte subpopulations, including the decline of uNK cells and macrophages and substantial increase in T lymphocytes and neutrophils. These data demonstrate an integral role of uNK cells and macrophages in early vascular remodeling and provide evidence of unique and complex immune interactions in the decidual microenvironment during human pregnancy.MAS