Kadyrov M, Schmitz C, Black S, Kaufmann P, Huppertz B
Department of Anatomy, University Hospital, Aachen, Germany.
Placenta. 2003 May;24(5):540-8. doi: 10.1053/plac.2002.0946.
During pregnancy extravillous trophoblast invades maternal uterine tissues and remodels spiral arteries. Maternal anaemia and early onset pre-eclampsia are associated with perturbed trophoblast biology. We systematically compared numerical density, invasive depth and apoptosis rates of extravillous trophoblast in uterine tissues taken from hysterectomies following Caesarean section after normal pregnancies (n=4) or pregnancies complicated by pre-eclampsia (n=5) or anaemia (n=6). Full thickness sections of the placental bed were studied by immunohistochemistry using anti-active caspase 3, anti-cytokeratin 7, anti-lamin B, M30, Mib-1, anti-PARP, and by the TUNEL assay. In normal pregnancy extravillous trophoblast invaded 2.04+/-0.19 mm (mean+/-SEM ) from the endometrial-myometrial border into the myometrium; in pre-eclampsia 0.67+/-0.14 mm (P< 0.01), and in anaemia 3.84+/-0.21 mm (P< 0.001). The endometrial trophoblast density in normal pregnancy was 2.44+/-0.37 cells per 60,000 microm(3), in pre-eclampsia was 1.04+/-0.15 (P< 0.01), and in anaemia was 3.10+/-0.32. The rate of apoptotic extravillous trophoblast (M30-positive) in the endometrium in normal pregnancy was 7.17+/-1.46 per cent, in pre-eclampsia 4.4+/-0.71, and in anaemia 2.1+/-0.42 (P< 0.01). Maternal anaemia leads to general tissue hypoxia throughout gestation. Increased invasive depth could be explained by hypoxia-stimulated mitosis and decreased apoptosis of extravillous trophoblast. Reduced trophoblast invasion in pre-eclampsia cannot be explained by higher rates of apoptosis.
孕期，绒毛外滋养层侵入母体子宫组织并重塑螺旋动脉。母体贫血和早发型子痫前期与滋养层生物学异常有关。我们系统比较了正常妊娠剖宫产术后子宫切除术（n = 4）、子痫前期妊娠剖宫产术后子宫切除术（n = 5）或贫血妊娠剖宫产术后子宫切除术（n = 6）所取子宫组织中绒毛外滋养层的数量密度、侵入深度和凋亡率。使用抗活性半胱天冬酶3、抗细胞角蛋白7、抗层粘连蛋白B、M30、Mib - 1、抗聚（ADP - 核糖）聚合酶抗体以及通过TUNEL法，对胎盘床的全层切片进行免疫组织化学研究。正常妊娠时，绒毛外滋养层从子宫内膜 - 肌层边界侵入肌层的深度为2.04±0.19毫米（平均值±标准误）；子痫前期时为0.67±0.14毫米（P < 0.01），贫血时为3.84±0.21毫米（P < 0.001）。正常妊娠时子宫内膜滋养层密度为每60,000立方微米2.44±0.37个细胞，子痫前期时为1.04±0.15（P < 0.01），贫血时为3.10±0.32。正常妊娠时子宫内膜中凋亡的绒毛外滋养层（M30阳性）比例为7.17±1.46%，子痫前期时为4.4±0.71%，贫血时为2.1±0.42%（P < 0.01）。母体贫血导致整个孕期全身组织缺氧。侵入深度增加可能是由于缺氧刺激的有丝分裂以及绒毛外滋养层凋亡减少所致。子痫前期时滋养层侵入减少无法用更高的凋亡率来解释。
