The immunophenotype of amniotic fluid leukocytes in normal and complicated pregnancies

Nardhy Gomez-Lopez, Roberto Romero, Yi Xu, Derek Miller, Yaozhu Leng, Bogdan Panaitescu, Pablo Silva, Jonathan Faro, Ali Alhousseini, Navleen Gill, Sonia S. Hassan, Chaur Dong Hsu

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


Problem: The immune cellular composition of amniotic fluid is poorly understood. Herein, we determined: 1) the immunophenotype of amniotic fluid immune cells during the second and third trimester in the absence of intra-amniotic infection/inflammation; 2) whether amniotic fluid T cells and ILCs display different phenotypical characteristics to that of peripheral cells; and 3) whether the amniotic fluid immune cells are altered in women with intra-amniotic infection/inflammation. Method of Study: Amniotic fluid samples (n = 57) were collected from 15 to 40 weeks of gestation in women without intra-amniotic infection/inflammation. Samples from women with intra-amniotic infection/inflammation were also included (n = 9). Peripheral blood mononuclear cells from healthy adults were used as controls (n = 3). Immunophenotyping was performed using flow cytometry. Results: In the absence of intra-amniotic infection/inflammation, the amniotic fluid contained several immune cell populations between 15 and 40 weeks. Among these immune cells: (i) T cells and ILCs were greater than B cells and natural killer (NK) cells between 15 and 30 weeks; (ii) T cells were most abundant between 15 and 30 weeks; (iii) ILCs were most abundant between 15 and 20 weeks; (iv) B cells were scarce between 15 and 20 weeks; yet, they increased and were constant after 20 weeks; (v) NK cells were greater between 15 and 30 weeks than at term; (vi) ILCs expressed high levels of RORγt, CD161, and CD103 (ie, group 3 ILCs); (vii) T cells expressed high levels of RORγt; (viii) neutrophils increased as gestation progressed; and (ix) monocytes/macrophages emerged after 20 weeks and remained constant until term. All of the amniotic fluid immune cells, except ILCs, were increased in the presence of intra-amniotic infection/inflammation. Conclusion: The amniotic fluid harbors a diverse immune cellular composition during normal and complicated pregnancies.

Original languageEnglish (US)
Article numbere12827
JournalAmerican Journal of Reproductive Immunology
Issue number4
StatePublished - Apr 2018
Externally publishedYes


  • B cells
  • T cells
  • bacteria
  • fetal immunity
  • immune cells
  • innate lymphoid cells
  • intra-amniotic infection
  • intra-amniotic inflammation
  • leukocytes
  • macrophages
  • microbes
  • microbial invasion of the amniotic cavity
  • monocytes
  • mucosal immunity
  • natural killer (NK) cells
  • neutrophils

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Reproductive Medicine
  • Obstetrics and Gynecology


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