Comparative Histological and Immunohistochemical Study in Normotensive and Preeclamptic Human Placental Tissue

Document Type : Original articles

Authors

Medical Histology and Cell Biology Department Faculty of Medicine, Beni-Suef University

Abstract

Background: The leading causes of maternal and neonatal death and morbidity globally continue to be preeclampsia (PE) and eclampsia. Aim of the work: present study was designed to compare histopathological changes, cell to cell adhesion and apoptotic changes in both normotensive and preeclamptic human placenta, using histological, immunohistochemical and morphometric methods. Patients and methods: Sixty pregnant women were included; 30 were normal clinically and considered the control group (group I) and the other 30 were included in the preeclampsia group (group II). Placental tissue was taken from pregnant women aged 25 to 35 who had had a caesarean section in order to end their pregnancy at Obstetric and Gynecology Department, Faculty of medicine, Beni-Suef University Hospital. Sections of placenta were processed and stained with Masson's trichrome, H&E, and immunostained for Bcl-2 and IL-10. Results: Group II (PE) revealed marked elevation in the number of syncytial knots, significant elevation in area percent of collagen fibers, and significant elevation in area percent of IL-10 immunoexpression as compared to group I. But there was marked reduction in the area percent of Bcl-2 immunoexpression. Conclusion: It can be concluded that Preeclampsia is associated with marked inflammatory and immune responses. Bcl-2 and IL-10 are extremely crucial in its pathogenesis. Therefore, they could be possible predictors for PE; in addition, therapeutic agents that can modulate the immune system might hold great promise in its early detection and prevention.

Keywords

Main Subjects


  1. Weiner E, Mizrachi Y, Grinstein E, Feldstein O, Haskel NR, et al. The role of placental histopathological lesions in predicting recurrence of preeclampsia. Prenatal diagnosis, 2016; 36(10): 953- 960.
  2. Gathiram P and Moodley J. Pre-eclampsia: its pathogenesis and pathophysiology. Cardiovasc J Afr, 2016; 27(2): 71-78.
  3. Obut M and Oğlak SC. Expression of CD44 and IL-10 in normotensive and preeclamptic placental tissue. Ginekologia Polska, 2020; 91(6): 334-341.
  4. Peterson LS, Stelzer IA, Tsai AS, Ghaemi MS, Han X, et al. Multiomic immune clockworks of pregnancy. In Seminars in immunopathology. Springer Berlin Heidelberg, 2020; 42 (4): 1-16.
  5. Hitti J, Sienas L, Walker S, Benedetti TJ, Easterling T. Contribution of hypertension to severe maternal morbidity. Am J Obstet Gynecol, 2018; 219:405. 1–7.
  6. Peres GM, Mariana M, Cairrão E. Pre-Eclampsia and Eclampsia: An Update on the Pharmacological Treatment Applied in Portugal. J Cardiovasc Dev Dis, 2018; 5(1):3.
  7. Thapa R and Wilson GD. The Importance of CD44 as a Stem Cell Biomarker and Therapeutic Target in Cancer. Stem Cells Int, 2016; 11(1): 1-23.
  8. Rojas J, Avia M, Martín V, Sevilla N. IL-10: a multifunctional cytokine in viral infections. J Immunol Res, 2017; 180(9), 5771- 5777.
  9. Behram M, Oğlak SC, Doğan Y. Evaluation of BRD4 levels in patients with early-onset preeclampsia. Journal of Gynecology Obstetrics and Human Reproduction, 2021; 50(2), 101963.
  10. Walentin K, Hinze C, Schmidt-Ott KM. The basal chorionic trophoblast cell layer: An emerging coordinator of placenta development. Bioes-says, 2016; 38(3): 254–265.
  11. Saputra NPK, Lipoeto NI, Machmud R. Analyses of nutrients and body mass index as risk factor for preeclampsia. The Journal of Obstetrics and Gynecology of India, 2017; 67(6): 409-413.
  12. Kiernan JK. Histological and Histochemical methods. In: Theory and practice. Arnold Publisher, London, New York, and New Delhi, 2008; (3) 111-162.
  13. Suvarna CH, Harikumar K, Ramunaik M. A review on hyperlipidemic. Int J novel trends in pharmaceut sci, 2013; 3(4): 59-71.
  14. Bancroft JD, Layton C. The hematoxylin and eosin, connective and mesenchymal tissues with their ains. In: Suvarna SK, Layton C and Bancroft JD, editors. Bancroft’s Theory and Practice of Histological Techniques, Churchill Living one, Philadelphia, 2013; 7(10):173 - 212.
  15. Bhargava P, Kadin ME. Immunohistology of Hodgkin Lymphoma. Diagnostic Immunohistochemistry, 2011; 3 (2):58-82.
  16. .Emsley R, Dunn G, White I. Mediation and moderation of treatment effects in randomized controlled trials of complex interventions. Stat Methods Med Res, 2010; 19(3): 237–270.
  17. Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. BMJ, 2019; 366 (l2381): 1-15.
  18. Lewis RB, Raspollini MR, Roberts D. Pathologic abnormalities of placental structure and function in diabetes. In Textbook of Diabetes and Pregnancy, 2018; (pp. 91-96).
  19. Redline R and Ravishankar S. Fetal vascular malperfusion, an update. APMIS, 2018; 126(7):561-569.
  20. Li X, Zhang W, Lin J, Liu H, Yang Z, Teng Y, et al. Hypertensive disorders of pregnancy and risks of adverse pregnancy outcomes: a retrospective cohort study of 2368 patients. Journal of Human Hypertension, 2020; 35(1), 65-73.
  21. Campbell C and Rudensky A. Roles of Regulatory T Cells in Tissue Pathophysiology and Metabolism. Cell Metab, 2020; 31: 18-25.
  22. Ziegler S, Weiss E, Schmitt A, Schlegel J, Burgert A, et al. CD56 is a pathogen recognition receptor on human natural killer cells. Sci Rep, 2017; 7(6138): 1-13.
  23. Paul S, Lal G T. The Molecular Mechanism of Natural Killer Cells Function and Its Importance in Cancer Immunotherapy. Front Immunol, 2017; 8(1124): 1-15.
  24. Stenhouse C, Hogg CO, Ashworth CJ. Associations between fetal size, sex and both proliferation and apoptosis at the porcine feto[1]maternal interface. Placenta, 2018; 70: 15-24.
  25. Nakanishi TO, Asanoma K, Fujikawa M, Fujita Y, Yagi H, et al. Fibrosis in preeclamptic placentas is associated with stromal fibroblasts activated by the transforming growth factor-β1 signaling pathway. Am J Pathol, 2018; 188(3): 683-695.
  26. Vishnyakova P, Elchaninov A, Fatkhudinov T, Sukhikh G. Role of the monocyte-macrophage system in normal pregnancy and preeclampsia. Int J Mol Sci, 2019; 20(15): 3695: 1-17.
  27. Ma Y, Ye Y, Zhang J, Ruan CC, Gao PJ. Immune imbalance is associated with the development of preeclampsia. Medicine (Baltimore), 2019; 98 (15080): 1-6.
  28. Su M, Hu Z, Dong C, Xu X. Vascular endothelial growth factor gene polymorphisms and hypertensive disorder of pregnancy: A meta-analysis. Pregnancy Hypertens, 2019; 17: 191-196
  29. Wheeler KC, Jena MK, Pradhan BS, Nayak N, Das S, et al. VEGF may contribute to macrophage recruitment and M2 polarization in the decidua. PLoS ONE, 2018; 13(1): 0191040: 1-18.
  30. Kobayashi H, Ichikawa M, Akasaka J, Tsunemi T, Sado T. Immune related pathophysiological causes relevant to a subset of patients with preeclampsia (Review). World Acad Sci J, 2019; 1(2): 59-66.
  31. .Ferguson KK, Meeker JD, McElrath TF, Mukherjee B, Cantonwine DE. Repeated measures of inflammation and oxidative stress biomarkers in preeclamptic and normotensive pregnancies. Am J Obst Gynecol, 2017; 216(5):527.
  32. Cakir SC, Dorum BA, Koksal N, Ozkan H. The effects of maternal preeclampsia on inflammatory cytokines and clinical outcomes in premature infants. Pakistan journal of medical sciences, 2020; 36(2): 26