Macrophage polarisation in caesarean scar diverticulum

作者：Huang, Jinfa; Liu, Xiaochun; Hou, Yi; Liu, Yixuan; Liao, Kedan; Xie, Ning; Deng, Kaixian^*

来源：Journal of Clinical Pathology - Clinical Molecular Pathology, 2023, 76(6): 379-383.

DOI：10.1136/jclinpath-2021-207926

• inflammation
• macrophages
• uterus
• fibrosis

Aims To determine immunohistochemical features and correlations between M1/M2 polarisation status with disease severity of post-caesarean scar diverticulum (CSD). Methods Histological and immunohistological stainings were performed and inflammatory (CD16, CD163 and tumour necrosis factor-alpha (TNF-alpha)), fibrosis (alpha-smooth muscle actin (alpha-SMA)) and angiogenic (CD31) markers were examined in uterine tissues collected from patients with uterine scar diverticula (CSD) (n=37) and caesarean section (CS) (n=3). Results CSD tissues have higher expression of alpha-SMA, TNF-alpha, CD16 and CD31 and lower expression of CD163 than CS tissue (p<0.05). Compared with adjacent tissues, thick-walled blood vessels, glands and fibrotic sites have higher expression of alpha-SMA, TNF-alpha and CD16. Statistical correlation was observed between the expression of CD16 and TNF-alpha (R=0.693, p<0.001), alpha-SMA (R=0.404, p<0.05) and CD31 (R=0.253, p<0.05) in CSD tissues, especially with the ratio of CD16/CD163 (R=0.590, p<0.01). A more significant difference was observed between the expression of CD16/CD163 and alpha-SMA (R=0.556, p<0.001), TNF-alpha (R=0.633, p<0.0001) and CD31 (R=0.336, p<0.05). Conclusions In this study, TNF-alpha, alpha-SMA, CD16 and CD31 proteins were overexpressed in all CSD cases, and CD16/CD163 was positively correlated with tissue inflammation, fibrosis and neovascularisation. Abnormal mononuclear macrophage infiltration may be involved in the origin and progression of CSD.

• 单位
  南方医科大学