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Human dNK cell function is differentially regulated by extrinsic cellular engagement and intrinsic activating receptors in first and second trimester pregnancy

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Cellular & Molecular Immunology 2017年第2期14卷 203-213页

作者： Jianhong Zhang Caroline E Dunk Melissa Kwan Rebecca L Jones Lynda K Harris sarah keating Stephen J Lye Research Centre for Women's and Infants' Health Lunenfeld-Tanenbaum Research Institute Mount Sinai Hospital Toronto ON M5T 3H7 Canada Department of Obstetrics & Gynaecology University of Toronto Toronto ON M5G 1 L4 Canada Department of Physiology University of Toronto Toronto ON M5G 1L4 Canada Institute of Human Development University of Manchester Manchester M 13 9WL UK St. Mary's Hospital Central Manchester University Hospitals NHS Foundation Trust Manchester Academic Health Science Centre Manchester M13 9WL UK Department of Pathology University of Toronto Toronto ON M5G 1L4 Canada

Decidual natural killer （dNK） cells express an array of activation receptors to regulate placental immunity and development during early pregnancy. We investigated the functional character of human dNK cells during the first and second trimester of gestation and the interaction between dNK and trophoblast cells. Although the frequency of CD56＋CD16-dNK among the total CD45＋ leukocytes did not change over this period, the expression of the activating receptors, NKp80 and NKG2D, was greatly upregulated. We observed a significantly higher number of extravillous trophoblast cells in proximity to the dNK cells in the first trimester in comparison with the second trimester decidua. NKG2D expression by first trimester dNK cells was decreased when co-cultured with the HTR-8 trophoblast cell line. In the second trimester, functional markers of dNK activation, i.e., angiogenic factor production （e.g., vascular endothelial growth factor, interleukin-8, interferon-gamma）, remained stable despite an increase in NKp80 or NKG2D surface expression. Furthermore, the degranulation capacity of dNK cells, as assessed by CD107a, was decreased in the second trimester. We suggest that in the first trimester, trophoblast-dNK interactions generate a population of dNK cells with a suppressed activating phenotype. In the second trimester, the loss of trophoblast-dNK interactions led to the inhibition of dNK cell function, although their activating receptor expression was increased. We speculate that during pregnancy, two mechanisms operate to modulate the dNK cell activation：suppression of activating receptor levels in the first trimester by trophoblasts and disengagement of receptor-ligand coupling in the second trimester.

关键词： decidual NK cells IFN-gamma NKG2D NKp80 pregnancy

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Is routine measurement of international normalized ratio necessary as part of the investigation of patients with cardiac-type chest pain?

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World Journal of Emergency Medicine 2021年第3期12卷 221-224页

作者： Samuel G.Campbell Kirk Magee Ismail Cajee Simon Field Michael B.Butler Christine L.Campbell sarah E.Bryson Charles V.keating Emergency and Trauma Centre Queen Elizabeth II HSCHalifaxNova Scotia B3H 3A7Canada

Dear editor, Chest pain is a frequent complaint of patients presenting to the emergency department (ED), and many of them are referred to the cardiology service for further investigation. At the Charles V. keating Emergency and Trauma Centre in Halifax, Nova Scotia, Canada, 4,800 (6.6%) of the approximately 73,000 patients per year register with a complaint of “chest pain”, and 20% of patients are referred to cardiology. Coagulation studies, specifi cally international normalized ratio (INR) frequently part of the “routine” panel of blood tests, are ordered for patients in the ED being investigated or treated for chest pain suspected to be cardiac in nature. Recent calls to examine how much of our practice is likely to benefit patients in any way have led us to question the clinical utility of routine use of these tests.

关键词： routine patients pain

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