Publication: Increased immunohistochemical expression of thrombomodulin at placental
perivascular myofibroblast in severe preeclampsia (PE)
Authors
Bosco, C. ; Parra, M. ; Barja, P. ; Rodrigo, R. ; Fernández, V. ; Suarez, M. ; Muñoz, H.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
The presence of pro-coagulant and anticoagulant
components of the placental vascular
endothelium and syncytiotrophoblast are essential for
homeostasis. Vascular endothelium prevents blood clot
formation in vivo by involving a cell surface thrombinbinding
glycoprotein, thrombomodulin (TM), that
activates plasma anti-coagulant protein C. The TM
levels increase during pregnancy, but the fibrinolytic
capacity diminishes. Since vascular lesions with
placental coagulation disorders can be associated with
preeclampsia (PE), we hypothesized that TM expression
in the stem villous vasculature and syncytiotrophoblast
of the placenta are impaired in PE. Plasma and placental
tissue samples were collected from PE (n=12) and
normotensive pregnant patients (n=11). Patient’s
gestational age was 35.7±1.2 (normotensive) and
30.6±1.5 weeks (PE). Blood samples were drawn 30 min
before delivery. Serum PAI-1 and PAI-2 antigens were
determined by enzyme-linked immunoabsorbent assay
(ELISA). A monoclonal antibody specific for TM was
used for immunohistochemical tissue staining (ABC)
and the staining was quantified by semi quantitative
scores. Results show no intensity differences at the apical syncytiotrophoblast between the two groups.
However, in preeclamptic placenta, TM expression
diminished in the endothelium of the stem villi arteries
and increased in the perivascular and stromal
myofibroblats in cases of severe PE. TM changes were
associated with an increased PAI-1/PAI-2 ratio.
It is suggested that in severe PE, the decreased
placental blood flow may be due to structural and
functional impairment of the endothelium of the stem
villi vessels and the surrounding perivascular and
stromal myofibroblast, by increasing TM expression
which may modulate fetal blow flow in the villous tree.
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