Expression of cytokeratin and vimentin in villi of the chorion with anteintranatal fetal death on the background of complicated pregnancy
Abstract
Abstract. Approximately 3–10 % of all pregnancies are complicated by premature rupture of membranes (PRM). Pregnancy in the presence of preeclampsia, gestational iron deficiency anemia, and acute chorioamnionitis increases the risk of PRM development. These complications of pregnancy are etiologically related to the factors causing PRM, the most important of which are oxidative stress with the subsequent development of sterile inflammation, droplet bleeding with the formation of a posterior placental hematoma, and inflammation of the placenta and fetal membranes. Aim. To determine the expression of cytokeratin and vimentin in chorionic villi with ante-intranatal death of fetuses against the background of complicated pregnancy. Materials and methods. The first studied group included 8 cases of PEN; in the second group – 8 PED observations; in the third group – 8 cases of AN; on the fourth – 8 cases of AD; in the fifth – 10 observations of KHAN; in the sixth – 16 cases of HAD. For the immunohistochemical (IGH) study, an indirect immunoperoxidase method was used using MCA for cytokeratin pan (AE-1/AE-3) (DAKO, Denmark) – epithelial cells were identified, and MCA for vimentin (V9) (DAKO, Denmark) - mesenchymal cells were identified cells. Results. In clinical groups with preterm pregnancy, the intensity of the reaction was well expressed in the epithelium of normal villi and unevenly expressed or absent in immature and sclerosed villi. The level of expression of cytokeratin by the epithelium of the villi in these groups was significantly higher compared to the CG group. In the groups with full-term pregnancy, the intensity of the IHC reaction was weakly expressed in the epithelium of normal villi and weakly expressed or absent in immature and sclerosed villi. The level of expression of cytokeratin by the epithelium of the villi in these groups was significantly lower compared to both the CG group and premature pregnancy in the case of similar pathology. In clinical groups with full-term pregnancy, the expression level of vimentin in mesenchymal cells of villi increased significantly compared to clinical groups with similar pathology of prematurity and compared to the CG group. Conclusions. In the villi of the chorion, some cells of the syncytial epithelium are transformed into mesenchymal cells with fibroblast-like properties, which can be confirmed by the appearance of vimentin-positive epithelial cells in the syncytiotrophoblast of the villi.
Downloads
References
Giannakou K. Perinatal epidemiology: Issues, challenges, and potential solutions. Obstet Med. 2021 Jun;14(2):77-82. DOI: https://doi.org/10.1177/1753495X20948984
WHO Global Maternal Sepsis Study (GLOSS) Research Group. Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study. Lancet Glob Health. 2020 May;8(5):e661-e671. DOI: https://doi.org/10.1016/S2214-109X(20)30109-1
Okafor O, Roos N, Abdosh AA, Adesina O, Alaoui Z, Romero WA, et. al. International virtual confidential reviews of infection-related maternal deaths and near-miss in 11 low- and middle-income countries - case report series and suggested actions. BMC Pregnancy Childbirth. 2022 May 23; 22 (1): 431. DOI: https://doi.org/10.1186/s12884-022-04731-x
Enjamo M, Deribew A, Semagn S, Mareg M. Determinants of Premature Rupture of Membrane (PROM) Among Pregnant Women in Southern Ethiopia: A Case-Control Study. Int J Womens Health. 2022 Mar 31;14:455-466. DOI: https://doi.org/10.2147/IJWH.S352348
Ghafoor S. Current and Emerging Strategies for Prediction and Diagnosis of Prelabour Rupture of the Membranes: A Narrative Review. Malays J Med Sci. 2021 Jun;28(3):5-17. DOI: https://doi.org/10.21315/mjms2021.28.3.2
Wang YX, Mínguez-Alarcón L, Gaskins AJ, Missmer SA, Rich-Edwards JW, Manson JE, Pan A, Chavarro JE. Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study. BMJ. 2021 Mar 24;372:n530. DOI: https://doi.org/10.1136/bmj.n530
Chan MY, Smith MA. Infections in Pregnancy. Comprehensive Toxicology. 2018:232–49. DOI: https://doi.org/10.1016/B978-0-12-801238-3.64293-9
Vousden N, Lawley E, Seed PT, Gidiri MF, Goudar S, Sandall J, Chappell LC, Shennan AH; CRADLE Trial Collaborative Group. Incidence of eclampsia and related complications across 10 low- and middle-resource geographical regions: Secondary analysis of a cluster randomised controlled trial. PLoS Med. 2019 Mar 29;16(3):e1002775. DOI: https://doi.org/10.1371/journal.pmed.1002775
Zhang Q, Lu XM, Zhang M, Yang CY, Lv SY, Li SF, Zhong CY, Geng SS. Adverse effects of iron deficiency anemia on pregnancy outcome and offspring development and intervention of three iron supplements. Sci Rep. 2021 Jan 14;11(1):1347. DOI: https://doi.org/10.1038/s41598-020-79971-y
Ota E, da Silva Lopes K, Middleton P, Flenady V, Wariki WM, Rahman MO, Tobe-Gai R, Mori R. Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2020 Dec 18;12(12):CD009599. DOI: https://doi.org/10.1002/14651858.CD009599.pub2
Menon R, Richardson LS, Lappas M. Fetal membrane architecture, aging and inflammation in pregnancy and parturition. Placenta. 2019 Apr;79:40-45. DOI: https://doi.org/10.1016/j.placenta.2018.11.003
Bhunia S, O’Brien S, Ling Y, Huang Z, Wu P, Yang Y. New approaches suggest term and preterm human fetal membranes may have distinct biomechanical properties. Sci Rep. 2022 Mar 24;12(1):5109. DOI: https://doi.org/10.1038/s41598-022-09005-2
Chai M, Walker SP, Riley C, Rice GE, Permezel M, Lappas M. Effect of supracervical apposition and spontaneous labour on apoptosis and matrix metalloproteinases in human fetal membranes. Biomed Res Int. 2013;2013:316146. DOI: https://doi.org/10.1155/2013/316146
Menon R. Human fetal membranes at term: Dead tissue or signalers of parturition? Placenta. 2016 Aug;44:1-5. DOI: https://doi.org/10.1016/j.placenta.2016.05.013
Menon R, Richardson LS. Preterm prelabor rupture of the membranes: A disease of the fetal membranes. Semin Perinatol. 2017 Nov;41(7):409-419. DOI: https://doi.org/10.1053/j.semperi.2017.07.012
Zhao D, Zhang C, Ma J, Li J, Li Z, Huo C. Risk factors for iron deficiency and iron deficiency anemia in pregnant women from plateau region and their impact on pregnancy outcome. Am J Transl Res. 2022 Jun 15;14(6):4146-4153.
Garrido-Gomez T, Ona K, Kapidzic M, Gormley M, Simón C, Genbacev O, Fisher SJ. Severe pre-eclampsia is associated with alterations in cytotrophoblasts of the smooth chorion. Development. 2017 Mar 1;144(5):767-777. DOI: https://doi.org/10.1242/dev.146100
Konwar C, Price EM, Wang LQ, Wilson SL, Terry J, Robinson WP. DNA methylation profiling of acute chorioamnionitis-associated placentas and fetal membranes: insights into epigenetic variation in spontaneous preterm births. Epigenetics Chromatin. 2018 Oct 29;11(1):63. DOI: https://doi.org/10.1186/s13072-018-0234-9
Menon R, Peltier MR. Novel Insights into the Regulatory Role of Nuclear Factor (Erythroid-Derived 2)-Like 2 in Oxidative Stress and Inflammation of Human Fetal Membranes. Int J Mol Sci. 2020 Aug 26;21(17):6139. DOI: https://doi.org/10.3390/ijms21176139
Bakalis S, David AL. Successful outcome after spontaneous first trimester intra-amniotic haematoma and early preterm premature rupture of membranes. BMJ Case Rep. 2018 Nov 28;11(1):e224596. DOI: https://doi.org/ 10.1136/bcr-2018-224596
Qin ZJ, Xu Y, Du Y, Chen YL, Sun L, Zheng A. Intrauterine Hematoma in the First Trimester and Pregnancy Complications: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2022 Jun 17;9:892146. DOI: https://doi.org/10.3389/fmed.2022.892146
El-Sheikh Ali H, Loux SC, Kennedy L, Scoggin KE, Dini P, Fedorka CE, Kalbfleisch TS, Esteller-Vico A, Horohov DW, Erol E, Carter CN, Smith JL, Ball BA. Transcriptomic analysis of equine chorioallantois reveals immune networks and molecular mechanisms involved in nocardioform placentitis. Vet Res. 2021 Jul 8;52(1):103. DOI: https://doi.org/10.1186/s13567-021-00972-4
Menon R, Behnia F, Polettini J, Richardson LS. Novel pathways of inflammation in human fetal membranes associated with preterm birth and preterm pre-labor rupture of the membranes. Semin Immunopathol. 2020 Aug;42(4):431-450. DOI: https://doi.org/10.1007/s00281-020-00808-x
Lim R, Lappas M. Expression and function of macrophage-inducible C-type lectin (Mincle) in inflammation driven parturition in fetal membranes and myometrium. Clin Exp Immunol. 2019 Jul;197(1):95-110. DOI: https://doi.org/10.1111/cei.13281
Chen T, You Y, Jiang H, Wang ZZ. Epithelial-mesenchymal transition (EMT): A biological process in the development, stem cell differentiation, and tumorigenesis. J Cell Physiol. 2017 Dec; 232 (12): 3261–3272. DOI: https://doi.org/10.1002/jcp.25797
The Journal of V. N. Karazin Kharkiv National University, series Medicine has following copyright terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work, with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
