Parturition Clinical Trial
Official title:
The Shift From Monocytes to Neutrophils in Blood Samples of Women in Labor
Accumulating evidence suggest that the proliferative, invasive, and immune tolerance
mechanisms that malignant tumors use to establish a nutrient supply and evade or edit the
host immune response are similar to those used by the developing placenta during normal
pregnancy. In addition to the shared capacity for invading through normal tissues, both
cancer cells and cells of the developing placenta create a microenvironment supportive of
both immunologic privilege and angiogenesis.
CD11b+Gr1+ cells are a heterogeneous population of bone marrow-derived cells (BMDC) that
consist of immature myeloid cells (IMCs), and were first described as myeloid-derived
suppressor cells. In healthy individuals, IMCs that are generated in the bone marrow
differentiate into mature granulocytes, macrophages, or dendritic cells (DCs). These cells
have been shown to play an essential role in mediating immune suppression in animal models
of human tumors. As a result of tumor-induced alterations in myelopoiesis, IMCs have been
found in peripheral blood, lymphoid organs and the tumor tissue itself. An increased
population of IMCs was identified in patients with several tumor types. Accordingly, IMCs
detected in the peripheral blood of such patients bearing express the common myeloid marker
CD33 but lack markers of mature myeloid cells such as the MHC class II molecule HLADR.
IMCs have been shown to actively promote tumor growth and metastasis by modulating the
cytokine environment, and through vascular remodeling by promoting angiogenesis.
It has been demonstrated in our laboratory that IMCs infiltrate placentas of pregnant mice
and actively promote angiogenesis. These cells show striking similarity to IMCs that
populate malignant tumors. Accordingly, human placentas are also infiltrated by a
significant population of IMCs. Immunostaining of human placentas showed that IMCs comprise
around 25% ( range 10-40%) of total placental CD45+ bone marrow-derived hematopoietic cells
and that this population is located close to blood capillaries. We also demonstrated that
immature DCs, cells originally described to regulate the adaptive immune response, also
promote angiogenesis in models of choroidal neovascularization, endometriosis and tumors.
This is a retrospective study on patient's blood samples of pregnant women who came to
delivery in our department during 1.1.2014-31.12.2014, to compare the abundance of monocytes
and neutrophils in: 1. Term active labor. 2. Elective cesarean section.
According to our previous findings, we hypothesize that monocytes in active delivery will be
lower than in women without signs for labor. We also hypothesize that neutrophils will be
more abundant in active delivery than in women without signs for labor.
We plan to screen anonymous electronic data of women who delivered in our departement during
2014 according to the following eligible criteria, stratified into 2 categories: 1. Women
who were admitted in active labor. 2. Women who were admitted for elective Cesarean Section
without signs of labor.
We will compare the abundance of monocytes and neutrophils in blood counts that were taken
on admission day between the two populations.
n/a
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