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Updated: Jul 21, 2025

Three-dimensional Rendering and Analysis of Immunolabeled, Clarified Human Placental Villous Vascular Networks
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Characterizing Histopathologic Features in Pregnancies With Chronic Histiocytic Intervillositis Using Computerized

Chloe A Brady1, Tihesia Riley1,2, Gauri Batra3

  • 1From Tommy's Maternal and Fetal Health Research Centre, St Mary's Hospital, The University of Manchester, Manchester, United Kingdom (Brady, Riley, Crocker, Heazell).

Archives of Pathology & Laboratory Medicine
|July 25, 2023
PubMed
Summary
This summary is machine-generated.

Chronic histiocytic intervillositis (CHI) involves significant maternal immune cell infiltration in the placenta. Objective analysis revealed increased macrophages in CHI, with recurrence in 18.2% of subsequent pregnancies, suggesting a potential role for computerized diagnostics.

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Area of Science:

  • Reproductive immunology
  • Pathology
  • Perinatal medicine

Background:

  • Chronic histiocytic intervillositis (CHI) is a rare placental condition linked to adverse pregnancy outcomes like fetal growth restriction and stillbirth.
  • Current diagnostic methods for CHI are subjective, hindering research and treatment development.
  • The etiology and effective treatments for CHI remain poorly understood.

Purpose of the Study:

  • To objectively quantify inflammatory cells and fibrin in placentas affected by CHI compared to controls.
  • To investigate changes in placental pathology in subsequent pregnancies after a CHI diagnosis.
  • To characterize the phenotype of macrophages in untreated CHI cases.

Main Methods:

  • Computerized analysis of immunohistochemically stained placental tissues from untreated CHI cases, subsequent pregnancies, and controls.
  • Immunofluorescence staining was used to identify M1 (CD80, CD86) and M2 (CD163, CD206) macrophage markers in CHI placentas.
  • Quantification of macrophage infiltration and fibrin deposition was performed.

Main Results:

  • A median 32-fold increase in macrophage infiltration was observed in CHI placentas compared to controls.
  • CHI recurred in 18.2% of subsequent pregnancies; however, 28.6% of diagnosed CHI cases did not show elevated infiltration.
  • Macrophages in CHI placentas predominantly expressed CD163, suggesting an anti-inflammatory role, while CD3+ T cells were elevated but normalized in subsequent pregnancies.

Conclusions:

  • Intervillous macrophages in CHI expressing CD163 may indicate an attempt to resolve inflammation.
  • Computerized analysis of placental inflammation can aid in assessing treatment efficacy and grading lesion severity in CHI.
  • Objective quantification of placental pathology is crucial for understanding CHI and its recurrence.