Ortega Miguel A, Fraile-Martinez Oscar, García-Montero Cielo, Rodriguez-Martín Sonia, Funes Moñux Rosa M, Pekarek Leonel, Bravo Coral, De Leon-Luis Juan A, Saez Miguel A, Guijarro Luis G, Lahera Guillermo, Monserrat Jorge, Rodriguez-Jimenez Roberto, Saz Jose V, Bujan Julia, García-Honduvilla Natalio, Alvarez-Mon Melchor, Alvarez-Mon Miguel Angel
Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain.
Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain.
Histol Histopathol. 2023 Oct;38(10):1109-1118. doi: 10.14670/HH-18-605. Epub 2023 Mar 7.
Psychosis is a hazardous and functionally disruptive psychiatric condition which may affect women in pregnancy, entailing negative consequences for maternofetal well-being. The precise pathophysiological basis and consequences of a psychotic episode in pregnancy remain to be further elucidated. The placenta is a pivotal tissue with many functions in the gestational period, critically influencing the fate and development of pregnancy. Although detrimental alterations have been observed in women undergoing severe psychiatric disorders in pregnancy, there are little studies evaluating the consequences of suffering from a psychotic episode in the placental tissue In this work, we have evaluated the histopathological consequences of a first episode of psychosis in pregnancy (FE-PW; N=22) and compare them with healthy pregnant women (HC-PW; N=20) by using histological, immunohistochemical and gene expression techniques. Our results define that the placental tissue of FE-PW display an increase in the number of placental villi, bridges, syncytial knots and syncytial knots/villi. Besides, we have also observed an enhanced gene and protein expression in FE-PW of the hypoxic marker HIF-1α, together with the apoptotic markers BAX and Bcl-2. To our knowledge, this is the first study demonstrating significant histopathological changes in the placenta of women suffering a new-onset psychotic episode in pregnancy. Further studies should be aimed at deepening the knowledge about the pernicious effects of psychosis in the maternofetal tissues, as well as the potential implications of these alterations.
精神病是一种具有危险性且会造成功能障碍的精神疾病,可能影响孕期女性,对母婴健康产生负面影响。孕期精神病发作的确切病理生理基础和后果仍有待进一步阐明。胎盘是妊娠期具有多种功能的关键组织,对妊娠的结局和发展起着至关重要的作用。虽然在孕期患有严重精神疾病的女性中已观察到有害改变,但评估胎盘组织中精神病发作后果的研究却很少。在这项研究中,我们通过组织学、免疫组织化学和基因表达技术,评估了孕期首次精神病发作(FE-PW;N=22)的组织病理学后果,并将其与健康孕妇(HC-PW;N=20)进行比较。我们的结果表明,FE-PW的胎盘组织中胎盘绒毛、桥、合体结节以及合体结节/绒毛的数量增加。此外,我们还观察到FE-PW中缺氧标志物HIF-1α以及凋亡标志物BAX和Bcl-2的基因和蛋白表达增强。据我们所知,这是第一项证明孕期首次发作精神病的女性胎盘存在显著组织病理学变化的研究。进一步的研究应旨在加深对精神病对母婴组织有害影响的认识,以及这些改变的潜在影响。