Department of General and Experimental Pathology, Medical University of Warsaw, Warsaw, Poland.
Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland.
Arch Gynecol Obstet. 2021 Aug;304(2):365-376. doi: 10.1007/s00404-021-05966-3. Epub 2021 Jan 26.
Impaired angiogenesis is one of the most common findings in preeclamptic placentas. A new angiogenetic role of fractalkine (CX3CL1) is recently recognized apart from inflammatory activity. In this study, a link between CX3CL1 and the development of placental vasculature in preeclampsia was examined.
The study comprised 52 women allocated to Group 1 (normotensive, n = 23) and Group 2 (preeclampsia, n = 29). In each group Doppler parameters, serum levels of CX3CL1, soluble fms-like tyrosine kinase-1 (sFlt-1), and placental growth factor (PlGF) were assessed between 30 and 32 week of pregnancy. After the delivery, placental samples were taken and the vascularization and expression of CX3CR1 receptor were assessed after immunostaining.
CX3CL1 and sFlt-1 serum levels were significantly higher levels in Group 2 vs Group 1, while PlGF serum levels was significantly lower in Group 2. Lower cerebroplacental ratio (CPR) was observed in Group 2. The vascular/extravascular tissue index (V/EVTI) was significantly lower in Group 2, while compared to Group 1, with the lowest value in the fetus growth restriction (FGR) subgroup (0.18 ± 0.02; 0.24 ± 0.03; 0.16 ± 0.02, respectively). The expression of examined CX3CR1 was higher in Group 2, while compared to Group 1, reaching the highest values in FGR subgroup. There was a moderate negative correlation between birth weight, V/EVTI and CX3CL1 serum level and CX3CR1 placental expression in the group of pregnancies complicated with preeclampsia.
The significant underdevelopment of placental vascular network in preeclampsia is associated with the change in the CX3CL1/CX3CR1 system, especially in FGR complicated pregnancies.
血管生成受损是子痫前期胎盘最常见的表现之一。除了炎症活动外，趋化因子 fractalkine（CX3CL1）的新血管生成作用最近也得到了认可。本研究旨在探讨 CX3CL1 与子痫前期胎盘血管发育之间的关系。
本研究纳入了 52 名孕妇，分为 1 组（血压正常，n=23）和 2 组（子痫前期，n=29）。在妊娠 30 至 32 周时，评估每组的多普勒参数、血清 CX3CL1、可溶性 fms 样酪氨酸激酶-1（sFlt-1）和胎盘生长因子（PlGF）水平。分娩后，取胎盘样本，通过免疫染色评估 CX3CR1 受体的血管化和表达。
与 1 组相比，2 组的血清 CX3CL1 和 sFlt-1 水平显著升高，而 PlGF 水平显著降低。2 组的脑-胎盘比值（CPR）较低。2 组的血管/血管外组织指数（V/EVTI）较低，与 1 组相比，胎儿生长受限（FGR）亚组的指数最低（分别为 0.18±0.02；0.24±0.03；0.16±0.02）。2 组的 CX3CR1 表达较高，与 1 组相比，FGR 亚组的表达最高。子痫前期组中，出生体重、V/EVTI 与 CX3CL1 血清水平及 CX3CR1 胎盘表达呈中度负相关。
子痫前期胎盘血管网络发育不良与 CX3CL1/CX3CR1 系统的变化有关，尤其是在伴有 FGR 的子痫前期孕妇中。
