الفهرس 
Introduction
Normal PregnancyOnly 14 pages are availabe for public view
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Abstract
This work was a cross section study, forty women with previous two or more unexplained repeated abortion and missed miscarriage of their current pregnancy were included. Four-colour flow cytometry analysis was carried out using a set of fluorochrome-labeled monoclonal antibodies against NK surface markers CD56, CD16, activatingCD161 and inhibitory CD158 KIRs. The mean age of patients was 28 ± 3.1 years. Their mean weight was 72 ± 7.2 Kg and 55% of them were overweight. The mean gestational age of the study population was 8 ± 2 weeks. History of early miscarriage was found in 65% of the patients and previous late miscarriage was also detected in 65% of them. In addition, 10% of the patients had a history of previous preterm delivery. The total percentage of NK (CD56+) cells from total lymphocytes in both peripheral blood and decidua of women with RSM at the time of miscarriage were 70% and 69%, respectively. CD56dim NK cells were significantly higher in the peripheral blood than in the decidua (91.6% ± 0.9vs.85.7% ±2, p= 0.003), whereas CD56bright NK cells were significantly higher in the decidua (9.7% ±2 vs. 5.1% ± 1, p= 0.01), especially those not expressing CD16 (5.8 % ± 1 vs. 1.9% ± 0.3, p= 0.01). The CD56dim CD16- NK cells were the predominating subset of NK cells (blood: 64.2% ± 3 and decidua: 61.4% ± 2) followed by CD56dim CD16dim (blood: 27.4 % ± 3 and decidua: 25.8% ± 2). Afterwards, was the CD56bright CD16- NK subset in decidua (5.8% ±1) then CD56dim CD16bright NK cells in blood (2.4% ± 0.4).Still, CD56bright CD16- cells were higher than the other CD56bright subsets in the decidua of RSA patients. No significant differences were observed among the three CD56dim NK cell subsets and the two CD 56bright CD16+ subsets between blood and decidua. In the meantime, CD56dim NK in blood showed direct relation with the CD56dim NK in the decidua and inverse relation with the CD56bright NK cells in the decidua. Also, the CD56dim CD16dim NK subset in blood showed significant positive correlation with the CD56dimCD16dim NK subset in the decidua. No significant differences were detected in the expression levels of CD158 inhibitory KIR and CD161 activating KIR on different NK cell subsets between blood and decidua. The CD56dimCD16- and CD56dimCD16dim were the most abundant NK cell subsets with the highest percentage of cells expressing CD161 alone (blood 11.6 ± 0.9; decidua 11.8 ± 1.3 and blood 5.2 ± 0.4; decidua 6.3 ± 0.6, respectively). Also, the percentages of the cells expressing CD161 alone were significantly exceeding those solely expressing CD158, especially the CD56dim NK cell subsets. No significant differences were detected in the expression levels of CD158 inhibitory KIR and CD161 activating KIR on different NK cell subsets between blood and decidua. The highest percentage of all NK subsets in blood and decidua were co-expressing both CD161 and CD158 especially the CD161brightCD158bright NK cells (p- value <0.0001). CD56bright CD16bright/dim and CD56dim CD16bright NK cells were the main subsets co-expressing both CD161 and CD158 (p < 0.0001) in blood and decidua.