2020 Fiscal Year Final Research Report

Analysis of possible mechanism of miscarriage in women with septate uterus

Research Project

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Project/Area Number	18K09304
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 56040:Obstetrics and gynecology-related
Research Institution	Nippon Medical School
Principal Investigator	Takeshita Toshiyuki 日本医科大学, 大学院医学研究科, 大学院教授 (60188175)
Co-Investigator(Kenkyū-buntansha)	桑原慶充日本医科大学, 医学部, 准教授 (40373013) 根岸靖幸日本医科大学, 医学部, 准教授 (50644580) 小野修一日本医科大学, 医学部, 講師 (80465301)
Project Period (FY)	2018-04-01 – 2021-03-31
Keywords	中隔子宮 / 不育症 / 流産 / 樹状細胞 / ケモカイン / ケモカインレセプター / 子宮鏡下中隔切除術
Outline of Final Research Achievements	Septate uterus is associated with spontaneous abortion. However, immunological mechanisms for miscarriage in patients with septate uterus remain completely unknown. Immune cells, dendritic cells (DCs), macrophages, T cells, natural killer cells, invariant natural killer cells, and chemokine receptors in US and uterine myometrium tissue (UMT) were analyzed using flow cytometry and immunohistochemical staining. The percentage of CD141+ DCs in US was significantly lower than that in UMT. Both US and UMT showed CCR1 and CCR5 expression on CD141+ DCs; however, the production of chemokines, MIP-1α, RANTES, and MIP-3β was abundant in UMT-obtained viable cells. The accumulation of CD141+ DCs was lower in US than that in UMT. This phenomenon may be caused by low chemokine productions in US. Our findings support the benefit of surgical intervention for septate uterus-that is, the elimination of inappropriate implantation sites.
Free Research Field	産婦人科　不育症
Academic Significance and Societal Importance of the Research Achievements	中隔子宮は流産や不育症の原因になると言われているが、そのメカニズムは明らかになっていなかった。本研究では免疫学的なアプローチによりそのメカニズムの一端を解明することができた。近年、適切な炎症は着床、妊娠初期に必要である事が報告されている。中隔子宮に対する手術療法の意義も明らかでなかったが、炎症性CD141+ DCsの欠如した中隔部を切除することは、本来起こるべき適切な炎症反応が起こらない部位を切除するという意味において、手術療法の妥当性を裏付けることになった。