Effects of trophoblast invasion on the distribution of leukocytes in uterine and tubal implantation sites  Ulrike von Rango, Ph.D., Irmgard Classen-Linke, Ph.D., Sonja Kertschanska, M.D., Birgit Kemp, M.D., Henning M Beier, Ph.D., M.D.  Fertility and Sterility  Volume 76, Issue 1, Pages 116-124 (July 2001) DOI: 10.1016/S0015-0282(01)01859-3

Figure 1 Immunohistochemical double staining for cytokeratin (blue-black) and various types of leukocytes (red) within the invasion front (zero to 25% trophoblast) in the uterus and fallopian tube in EP. A, C, E, G: Uterine decidua. B, D, F, H: Tubal implantation site. A, B: CD45+ leukocytes and cytokeratin. C, D: CD8+ T cells and cytokeratin. E, F: CD56+ NK cells and cytokeratin. G, H: CD68+ macrophages and cytokeratin. CD68+ macrophages and CD8+ T cells are closely associated with the invading trophoblast cells. The distribution pattern is similar for CD68+ macrophages and CD8+ T cells. In contrast, CD56+ NK cells are almost absent from the fallopian tube (original magnification, ×375). von Rango. Leukocytes at trophoblast invasion sites. Fertil Steril 2001. Fertility and Sterility 2001 76, 116-124DOI: (10.1016/S0015-0282(01)01859-3)

Figure 2 Numbers of CD45+ leukocytes in the various different trophoblast areas in the decidua (solid bars) and the fallopian tubal implantation site in EP (shaded bars). The “unit area” of 0.085 mm2 was chosen to allow the different trophoblast areas to be clearly distinguished. There were significant differences in the trophoblast areas defined according to the amount of trophoblast, and in the normal intrauterine and ectopic tubal implantation sites (results of statistical analysis are given in Table 1). von Rango. Leukocytes at trophoblast invasion sites. Fertil Steril 2001. Fertility and Sterility 2001 76, 116-124DOI: (10.1016/S0015-0282(01)01859-3)

Figure 3 Quantitative analysis of CD68+ macrophages, CD8+ T cells, CD56+ NK cells, and CD20+ B cells. There are significant differences in the different areas defined according to the amount of trophoblast (see Table 1). However, the distribution pattern of the leukocytes is similar for both intrauterine and tubal pregnancies, with the exception of the absence of CD56+ NK cells at the tubal implantation site (P<.0001). von Rango. Leukocytes at trophoblast invasion sites. Fertil Steril 2001. Fertility and Sterility 2001 76, 116-124DOI: (10.1016/S0015-0282(01)01859-3)

Figure 4 (A), Comparison of leukocyte numbers within the decidua parietalis (solid bars) and decidual tissue from EP (open bars). No significant differences in any of the leukocyte markers could be found between these two types of decidual tissue. (B), Comparison of leukocyte numbers in fallopian tube distant from the implantation site (shaded bars) and the tubal wall in the menstrual cycle (dark shaded bars). Significant differences between these sites were found only for CD45+ leukocytes and CD68+. Therefore CD68+ macrophages seem to be responsible for the difference in numbers of CD45+ leukocytes. von Rango. Leukocytes at trophoblast invasion sites. Fertil Steril 2001. Fertility and Sterility 2001 76, 116-124DOI: (10.1016/S0015-0282(01)01859-3)