Searching for influencers among placental immune cells in preeclampsia.

Cells in maternal and fetal immune systems may communicate, leading to immune tolerance during pregnancy; however, this hypothesis remains controversial. Here, we profiled single-cell transcriptional signatures in placental layers comprising the maternal-fetal interface and deep placenta, then searched for genes associated with preeclampsia. To investigate the underlying principle of the failure of immune tolerance, we started by clarifying the systemic framework, comprising models of immune interaction frequency (IIF) and specific triggers (i.e., influencers) of tolerance (IT). We generated single-cell transcriptional profiles of normal term (Norms) and preeclampsia preterm (PePT) parturitions. Fetal and maternal cells are admixed across the placenta, for both Norms and PePTs, rejecting the IIF model of immune failure during pregnancy posed by excessive interactions between fetomaternal cells. Whereas placental layers are well mixed with maternal cells, we identified a conserved gradual immune transition of fetal T-cells in both PePT and Norm, disproving the IIF model. To search for influencers of PePT in the IT model, we established and validated a classification model for PePT and Norm immune cells, including T-cells, and then prioritized major contributors to the classifier model, which are highly enriched in ligands and receptors (p = 5.98e-5). Among the prioritized ligand receptors, SPP1 and CD44 are suggested as influencers of inflammation signatures and were experimentally validated by the exclusive colocalization of SPP1- and CD44-expressing cells in the PePT placentas. Different interleukin-4 and interferon-{psi} levels in the serum and urine of PePTs further support the contribution of SPP1 to associated pathways, including allograft rejection. Our findings provide insight into the influence of specific immune interactions between cells in the human placenta and their influencer-derived impact on PePT.