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Published online June 26, 2009
The Journal of Immunology, 2009, 183, 1144 -1154
Copyright © 2009 by The American Association of Immunologists, Inc.
doi:10.4049/jimmunol.0900788

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TLR9 Activation Coupled to IL-10 Deficiency Induces Adverse Pregnancy Outcomes1

Jessica E. Thaxton*, Roberto Romero{dagger} and Surendra Sharma2,*

* Department of Pediatrics, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI 02905; and {dagger} Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health/Department of Health and Human Services, Detroit, MI 48201

Pregnancy outcome is severely compromised by intrauterine infections and inflammation. Although the pregnant uterine microenvironment is replete with innate immune cells and TLR expression, the mechanisms that facilitate adverse effects of their activation are largely unknown. In this study, we mimic the activation of TLR9 with its pathogenic ligand hypomethylated CpG and demonstrate that IL-10 proficiency protects against CpG-induced pregnancy complications. We show that fetal resorption and preterm birth are rapidly induced in IL-10–/– mice by low doses of CpG (~25 µg/mouse) when injected i.p. on gestational day 6 or gestational day 14, respectively. In contrast, wild-type mice failed to experience such effects at comparable doses, but pups born at term displayed craniofacial/limb defects in response to higher doses (~400 µg/mouse). Pregnancy complications in IL-10–/– mice were associated with unexpected and robust TLR9-triggered activation and amplification of uterine neutrophil and macrophage subpopulations followed by their migration to the placental zone. Furthermore, a dramatic increase in serum levels of mouse KC and TNF-{alpha} production by uterine F4/80+ cells, but not uterine NK or Gr-1+CD11b+ cells, was observed. Depletion of F4/80+ macrophages or neutralization of TNF-{alpha} rescued pregnancy to term. Our results have important implications for IL-10-mediated "uterine tolerance" against CpG-driven innate immune activation.

The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

1 This work was supported in part by a grant from National Institutes of Health, National Center for Research Resources (P20RR018728), The Intramural Division of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, and Subcontract WSU05056 under National Institute of Child Health and Human Development Contract N01-HD-2-3342. J.E.T. was supported by a Superfund Basic Research Program Award (P42ES013660) from the National Institute of Environmental Health Sciences.

2 Address correspondence and reprint requests to Dr. Surendra Sharma, Department of Pediatrics, Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905. E-mail address: ssharma{at}wihri.org

3 Abbreviations used in this paper: uNK, uterine NK; ODN, oligodeoxynucleotide; UMGC, uterine mononuclear and granular cells; DHR, dihydrorhodamine 123; gd, gestational day; ROS, reactive oxygen species; mKC, mouse KC.







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