Laskowska Marzena, Vinson Gavin P, Szumiło Justyna, Laskowska Katarzyna, Leszczyńska-Gorzelak Bozena, Oleszczuk Jan
Department of Obstetrics and Perinatology, University School of Medicine, Jaczewskiego 8, PL-20-950 Lublin, Poland.
Gynecol Obstet Invest. 2003;56(1):55-60. doi: 10.1159/000072704. Epub 2003 Jul 31.
The aim of this study was to compare the immunoreactivity of angiotensin-II receptor type 1 (AT1R) in the vascular endothelial cells of human placental vessels in normal and preeclamptic pregnancies. Immunohistochemistry was used to examine the localization of AT1R in the vascular endothelium of human placental vessels. In preeclamptic patients without intrauterine growth retardation (IUGR) the mean histological index H score was significantly higher, but significantly decreased in patients with preeclampsia complicated by IUGR in comparison with the control group. Immunolocalization of AT1R in vascular endothelial cells in our study supports the view that angiotensin II may play a role in the regulation of vascular tone and vascular resistance and the actions of other vasoactive factors, vasodilators or vasoconstrictors. However, our results confirmed that AT1R immunoreactivity is elevated in vascular endothelial cells of human placenta from pregnancies complicated by preeclampsia, suggesting a higher activity of the renin-angiotensin-aldosterone system (RAAS) in women with preeclampsia. On the other hand reduced immunoreactivity of AT1R in placental vascular endothelial cells in pregnancy complicated by preeclampsia with IUGR may result from chronic higher RAAS activity and may suggest the decreased ability to compensate and the inability to restore the normal balance between vasodilators and vasoconstrictors. These results may also reflect destructive changes and dysfunction of the vascular endothelium in preeclamptic pregnancy with IUGR.
本研究的目的是比较正常妊娠和子痫前期妊娠中人类胎盘血管内皮细胞中血管紧张素 II 1 型受体(AT1R)的免疫反应性。采用免疫组织化学方法检测 AT1R 在人类胎盘血管内皮中的定位。在无宫内生长受限(IUGR)的子痫前期患者中,平均组织学指数 H 评分显著更高,但与对照组相比,子痫前期合并 IUGR 的患者该评分显著降低。本研究中 AT1R 在血管内皮细胞中的免疫定位支持以下观点:血管紧张素 II 可能在血管张力和血管阻力的调节以及其他血管活性因子、血管舒张剂或血管收缩剂的作用中发挥作用。然而,我们的结果证实,子痫前期妊娠的人类胎盘血管内皮细胞中 AT1R 的免疫反应性升高,提示子痫前期女性肾素 - 血管紧张素 - 醛固酮系统(RAAS)活性更高。另一方面,子痫前期合并 IUGR 的妊娠中胎盘血管内皮细胞中 AT1R 的免疫反应性降低可能是由于 RAAS 长期处于较高活性,这可能提示其代偿能力下降以及无法恢复血管舒张剂和血管收缩剂之间的正常平衡。这些结果也可能反映了子痫前期合并 IUGR 妊娠中血管内皮的破坏性变化和功能障碍。