Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.
Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.
Placenta. 2021 Apr;107:1-7. doi: 10.1016/j.placenta.2021.03.001. Epub 2021 Mar 5.
Uteroplacental acute atherosis is frequently observed in preeclampsia, and shares features with early atherosclerotic lesions, including artery wall foam cells. The lipid-associated proteins FABP4 (fatty acid binding protein 4), perilipin-2, and LOX-1 (lectin-like oxidized LDL-receptor 1) are involved in atherosclerotic foam cell formation. Increased levels of these proteins have been associated with preeclampsia systemically and in placental tissue. Their role in acute atherosis is yet unidentified. Our aim was to describe the presence of these proteins in acute atherosis, and compare our findings to what is known in early atherosclerotic lesions.
Serial sections of decidua basalis tissue from 12 normotensive (4 with acute atherosis) and 23 preeclamptic pregnancies (16 with acute atherosis) were stained with HE and immunostained for CK7, CD68, FABP4, perilipin-2, and LOX-1. Artery wall and perivascular protein expression was assessed in 190 spiral artery sections; 55 with acute atherosis.
Acute atherosis foam cells were commonly positive for perilipin-2 (55%), less often for FABP4 (13%), and never for LOX-1. LOX-1 was frequently observed in intramural trophoblasts of normal spiral arteries. Perivascularly, LOX-1 positivity of decidual stromal cells surrounding arteries with acute atherosis was significantly increased as compared to arteries lacking acute atherosis (38% vs. 15%, p < 0.001).
We found that perilipin-2 and FABP4 are expressed by acute atherosis foam cells, similar to atherosclerosis, supporting possible shared pathways for foam cell generation. Unlike atherosclerosis, LOX-1 is not present in acute atherosis, possibly explained by pregnancy-specific routes to decidua basalis foam cell generation.
胎盘急性动脉粥样硬化在子痫前期中经常观察到，与早期动脉粥样硬化病变具有共同特征，包括动脉壁泡沫细胞。脂质相关蛋白 FABP4（脂肪酸结合蛋白 4）、 perilipin-2 和 LOX-1（凝集素样氧化型 LDL 受体 1）参与动脉粥样硬化泡沫细胞的形成。这些蛋白水平的升高与子痫前期全身和胎盘组织有关。它们在急性动脉粥样硬化中的作用尚未确定。我们的目的是描述这些蛋白在急性动脉粥样硬化中的存在，并将我们的发现与早期动脉粥样硬化病变中的已知情况进行比较。
从 12 例正常血压（4 例伴有急性动脉粥样硬化）和 23 例子痫前期妊娠（16 例伴有急性动脉粥样硬化）的蜕膜基底组织中连续切片，用 HE 染色和免疫组织化学染色检测 CK7、CD68、FABP4、 perilipin-2 和 LOX-1。在 190 个螺旋动脉切片中评估了动脉壁和血管周围的蛋白表达；55 个伴有急性动脉粥样硬化。
急性动脉粥样硬化泡沫细胞通常为 perilipin-2（55%）阳性，较少为 FABP4（13%）阳性，从未为 LOX-1 阳性。LOX-1 在正常螺旋动脉的壁内滋养细胞中经常观察到。与没有急性动脉粥样硬化的动脉相比，围绕伴有急性动脉粥样硬化的动脉的血管周围基质细胞的 LOX-1 阳性率显著增加（38%比 15%，p<0.001）。
我们发现 perilipin-2 和 FABP4 由急性动脉粥样硬化泡沫细胞表达，与动脉粥样硬化相似，支持泡沫细胞生成的可能共同途径。与动脉粥样硬化不同，LOX-1 不存在于急性动脉粥样硬化中，这可能是由于妊娠特异性途径导致蜕膜基底泡沫细胞生成。
