<meta charset="utf8"></head><body>Explorando a heterogeneidade das células NK uterinas no endométrio com IHC multiplex

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Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Single-cell+transcriptome+profiling+of+the+human+endometrium+of+patients+with+recurrent+implantation+failure.">Single-cell transcriptome profiling of the human endometrium of patients with recurrent implantation failure.</a> Theranostics. 12 (15), 6527-6547 (2022).</li><li>Coughlan, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recurrent+implantation+failure:+definition+and+management.">Recurrent implantation failure: definition and management.</a> Reprod BioMed Onl. 28 (1), 14-38 (2014).</li><li>Chen, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measurement+of+uterine+natural+killer+cell+percentage+in+the+periimplantation+endometrium+from+fertile+women+and+women+with+recurrent+reproductive+failure:+establishment+of+a+reference+range.">Measurement of uterine natural killer cell percentage in the periimplantation endometrium from fertile women and women with recurrent reproductive failure: establishment of a reference range.</a> Am J Obst Gyneco. 217 (6), 680.e1-680.e6 (2017).</li><li>Yang, W. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+comparison+of+uterine+natural+killer+cell+density+in+the+peri-implantation+period+between+natural+cycles+and+hormone+replacement+therapy+cycles.">A comparison of uterine natural killer cell density in the peri-implantation period between natural cycles and hormone replacement therapy cycles.</a> Am J Reprod Immunol. 82 (3), e13156 (2019).</li><li>Syed, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiplex+immunohistochemistry:+The+importance+of+staining+order+when+producing+a+validated+protocol.">Multiplex immunohistochemistry: The importance of staining order when producing a validated protocol.</a> Immunother. 5 (2), 1-9 (2019).</li><li>Lash, G. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Standardisation+of+uterine+natural+killer+(uNK)+cell+measurements+in+the+endometrium+of+women+with+recurrent+reproductive+failure.">Standardisation of uterine natural killer (uNK) cell measurements in the endometrium of women with recurrent reproductive failure.</a> J Reprod Immunol. 116, 50-59 (2016).</li><li>Mansfield, J. R., Gossage, K. W., Hoyt, C. C., Levenson, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Autofluorescence+removal,+multiplexing,+and+automated+analysis+methods+for+in+vivo+fluorescence+imaging.">Autofluorescence removal, multiplexing, and automated analysis methods for in vivo fluorescence imaging.</a> J Biomed Optics. 10 (4), 41207 (2005).</li><li>Hoyt, C. 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K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+of+endometrial+immune+cells+in+implantation.">Role of endometrial immune cells in implantation.</a> Clin Exp Reprod Med. 38 (3), 119-125 (2011).</li><li>Gothe, J. P., de Mattos, A. C., Silveira, C. F., Malavazi, K. 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T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Helper+(Th)+cell+profiles+in+pregnancy+and+recurrent+pregnancy+losses:+Th1/Th2/Th9/Th17/Th22/Tfh+cells.">Helper (Th) cell profiles in pregnancy and recurrent pregnancy losses: Th1/Th2/Th9/Th17/Th22/Tfh cells.</a> Front Immunol. 11, 2025 (2020).</li><li>Nagamatsu, T., Schust, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+contribution+of+macrophages+to+normal+and+pathological+pregnancies.">The contribution of macrophages to normal and pathological pregnancies.</a> Am J Reprod Immunol. 63 (6), 460-471 (2010).</li></ol>

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>CD49a</td>
			<td>Novus Biologicals</td>
			<td>NBP2-76478</td>
			<td>Primary antibodies</td>
		</tr>
		<tr>
			<td>CD56</td>
			<td>Leica</td>
			<td>NCL-L-CD56-504</td>
			<td>Primary antibodies</td>
		</tr>
		<tr>
			<td>CD16</td>
			<td>abcam</td>
			<td>ab183354</td>
			<td>Primary antibodies</td>
		</tr>
		<tr>
			<td>CXCR4</td>
			<td>R&#38;D</td>
			<td>MAB172</td>
			<td>Primary antibodies</td>
		</tr>
		<tr>
			<td>Amplification diluent</td>
			<td>Akoya Biosciences</td>
			<td>FP1498 series</td>
			<td>Fluorophore dilution buffer</td>
		</tr>
		<tr>
			<td>Antibody diluents</td>
			<td>Akoya Biosciences</td>
			<td>ARD1001EA</td>
			<td>Dilute the antibody</td>
		</tr>
		<tr>
			<td>Citrate buffered solution, pH 6.0 /9.0(10x)</td>
			<td>Akoya Biosciences</td>
			<td>A6001/A9001</td>
			<td>Antigen retrieval solution</td>
		</tr>
		<tr>
			<td>inForm advanced image analysis software</td>
			<td>Akoya Biosciences</td>
			<td>inForm Tissue Finder Software 2.2.6</td>
			<td>Data analysis software</td>
		</tr>
		<tr>
			<td>Mantra Workstations</td>
			<td>Akoya Biosciences</td>
			<td>CLS140089</td>
			<td>Spectral imaging</td>
		</tr>
		<tr>
			<td>microwave</td>
			<td>Akoya Biosciences</td>
			<td>inverter</td>
			<td>Microwave stripping</td>
		</tr>
		<tr>
			<td>TSA 520</td>
			<td>Akoya Biosciences</td>
			<td>FP1487001K</td>
			<td>Suitable tyramide-based fluorescent reagents</td>
		</tr>
		<tr>
			<td>TSA 620</td>
			<td>Akoya Biosciences</td>
			<td>FP1495001K</td>
			<td>Suitable tyramide-based fluorescent reagents</td>
		</tr>
		<tr>
			<td>TSA 650</td>
			<td>Akoya Biosciences</td>
			<td>FP1496001K</td>
			<td>Suitable tyramide-based fluorescent reagents</td>
		</tr>
		<tr>
			<td>TSA 570</td>
			<td>Akoya Biosciences</td>
			<td>FP1488001K</td>
			<td>Suitable tyramide-based fluorescent reagents</td>
		</tr>
		<tr>
			<td>Poly-L-lysine coated slides</td>
			<td>Fisher Technologies</td>
			<td>120-550-15</td>
			<td>Slides for routine histological use</td>
		</tr>
		<tr>
			<td>PolyHRP Broad Spectrum</td>
			<td>Perkin Elmer</td>
			<td>ARH1001EA</td>
			<td>Secondary antibodies</td>
		</tr>
		<tr>
			<td>Invitrogen&#8482;&#160;Fluoromount-G&#8482; Mounting Medium</td>
			<td>ThemoFisher Science</td>
			<td>495802</td>
			<td>Installation</td>
		</tr>
		<tr>
			<td>Spectral DAPI</td>
			<td>Akoya Biosciences</td>
			<td>FP1490A</td>
			<td>Nucleic acid staining</td>
		</tr>
	</tbody>
</table>

measurement of four uterine nk cell subtypes using multiplexed fluorescent immunohistochemical staining in women with repeated implantation failure

The first documented live birth after in vitro fertilization-embryo transfer (IVF-ET) was reported in 1978. Over the past 40 years, there has been a high demand for the assistance of IVF-ET among infertile couples1. In 2021, 238,126 patients initiated a total of 413,776 IVF cycles in the United States. This marks a 25% increase in cycles from 2 years prior and a 135% increase from 20122. This surge is mainly attributed to the rising prevalence of infertility and delayed planning for pregnancy. Advancements in embryo culture techniques and superovulation protocols have led to an increased live birth rate per ET cycle, reaching 30%-50% in women less than 40 years old and less than 30% in women older than 40 years2. However, despite these advancements, over half of transferred embryos still fail to implant. Repeated implantation failure (RIF), typically defined as failure after three or more consecutive attempts of transferring high-quality embryos, affects 15% of women who undergo IVF-ET3. Couples with RIF are extremely vulnerable and more prone to undergo expensive and unnecessary procedures that can expose them to undue risks4. Therefore, understanding the causes of RIF and improving embryo implantation is crucial to enhance the success of IVF-ET, particularly for women with RIF. The preparation of endometrium is critical for successful embryo implantation. This process is characterized by a significant accumulation of uterine natural killer (uNK) cells, which transition from constituting 30% of total lymphocytes in the endometrium during mid-secretory phase to 70%-80% in the decidua during early pregnancy5. Notably, uNK cells differ from peripheral NK cells, which are cytotoxic lymphocytes critical to the innate immune system for causing the death of the infected cells through lysis or apoptosis. While the exact functions of uNK cells are not yet fully understood, several lines of evidence suggest that they are involved in angiogenesis remodeling, trophoblast invasion, and fetal development6. The association between the percentage of uNK cells over stromal cells and RIF has garnered extensive attraction over the past 20 years. A recent meta-analysis, which included 8 studies involving 604 women, demonstrated that the density of CD56+uNK cells during the mid-luteal phase is significantly increased in women with RIF compared to fertile controls7. However, it is important to note that the characteristics of uNK cells during the mid-luteal phase differ significantly from those of decidual NK (dNK) cells. Although uNK cells may further differentiate into various subsets of dNK cells post-pregnancy, measuring uNK cells alone does not accurately represent dNK cells8. uNK cells undergo dynamic differentiation and play different roles in the menstrual cycle and decidualization processes, making them more complex than can be identified by CD56 alone. Multiple markers are required to achieve a comprehensive understanding of uNK cell behavior during endometrial preparation. Our recent study employed single-cell RNA sequencing to identify the diversity of uNK cells throughout menstrual cycles. The results, validated using flow cytometry, have shown the presence of four distinct subtypes of uNK cells, each exhibiting dynamic changes during the menstrual cycle9. Gene enrichment analysis and gene ontology functional enrichment indicate these uNK subsets fulfill different functions at various stages of menstruation. Nevertheless, flow cytometry is not universally accessible in clinical laboratories, and the immediate processing of fresh endometrial tissue for enzyme digestion renders it impossible to repeat experimental steps upon errors.
The aim of this study was, therefore, to investigate the measurement of these four subpopulations of NK cells using a multiplex staining assay, which provides a more practical diagnostic approach. In multiple staining, different specific antibodies against each target are linked to different fluorophore labels that emit different wavelengths of light when excited by a specific wavelength of light. Compared to the traditional IHC staining method, this method can quantitatively compare the relative abundance and distribution of multiple targets in a sample and provide information on the interaction and co-localization of different targets, enabling us to identify different subtypes of uNK cells. This approach will not only deepen our understanding of the relationship between uNK cells and RIF but will also provide insights for investigating other immune cell subpopulations in endometrial-related diseases.

<meta charset="utf8"></head><body>Autor em destaque: Imuno-histoquímica multiplex para entender a regulação imunológica por células NK uterinas na gravidez

Medição de quatro subtipos de células NK uterinas usando coloração imuno-histoquímica fluorescente multiplexada em mulheres com falha repetida de implantação

Uterine NK cells dramatically accumulate during the mid-luteal phase, prepared for embryo implantation. Notably, these cells are heterogeneous. Accurately identifying their phenotypes is crucial for understanding their roles in endometrial receptivity.Our study aims to detect four subtypes of uterine NK cells using multiplex immunohistochemistry staining. Immunohistochemistry staining has been widely used to measure uterine NK cell density in women with reproductive failure. However, this traditional technology does not effectively distinguish between different subtypes of uterine NK cells.Our protocol, using multiplex immunohistochemistry staining, offers an advanced approach to identify four distinct subtypes of uterine NK cells. With the implementation of this protocol, we will evaluate the differences in uterine NK cell subtypes between women with repeated implantation failure and the fertile controls. If significant differences are identified, we will proceed to investigate whether these uterine NK cell subtypes can predict the risk of implantation failure.Ultimately, our long-term goal is to develop a diagnostic test to assess the immune status of uterine NK cells for endometrial receptivity.

Immunohistochemistry (IHC) plays a crucial role in biological research and clinical diagnosis, serving as the most commonly used method for identifying ...

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Research

Measurement of Four Uterine NK Cell Subtypes Using Multiplexed Fluorescent Immunohistochemical Staining in Women with Repeated Implantation Failure

JoVE Journal

Medicine

522 visualizações.  The Chinese University of Hong Kong. As células NK uterinas se acumulam dramaticamente durante a fase lútea média, preparadas para a implantação do embrião. Notavelmente, essas células são heterogêneas. Identificar com precisão seus fenótipos é crucial para entender seus papéis na receptividade endometrial.Nosso estudo visa detectar quatro subtipos de células NK uterinas usando coloração imuno-histoquímica multiplex. A coloração imuno-histoquímica tem sido amplamente u...