Huang Chien-Chu, Hsueh Ya-Wen, Chang Chia-Wei, Hsu Hsi-Chen, Yang Tung-Chuan, Lin Wu-Chou, Chang Hsun-Ming
Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan.
Front Cell Dev Biol. 2023 May 17;11:1200330. doi: 10.3389/fcell.2023.1200330. eCollection 2023.
Early pregnancy is a complex and well-orchestrated differentiation process that involves all the cellular elements of the fetal-maternal interface. Aberrant trophoblast-decidual interactions can lead to miscarriage and disorders that occur later in pregnancy, including preeclampsia, intrauterine fetal growth restriction, and preterm labor. A great deal of research on the regulation of implantation and placentation has been performed in a wide range of species. However, there is significant species variation regarding trophoblast differentiation as well as decidual-specific gene expression and regulation. Most of the relevant information has been obtained from studies using mouse models. A comprehensive understanding of the physiology and pathology of human implantation and placentation has only recently been obtained because of emerging advanced technologies. With the derivation of human trophoblast stem cells, 3D-organoid cultures, and single-cell analyses of differentiated cells, cell type-specific transcript profiles and functions were generated, and each exhibited a unique signature. Additionally, through integrative transcriptomic information, researchers can uncover the cellular dysfunction of embryonic and placental cells in peri-implantation embryos and the early pathological placenta. In fact, the clinical utility of fetal-maternal cellular trafficking has been applied for the noninvasive prenatal diagnosis of aneuploidies and the prediction of pregnancy complications. Furthermore, recent studies have proposed a viable path toward the development of therapeutic strategies targeting placenta-enriched molecules for placental dysfunction and diseases.
早期妊娠是一个复杂且精心编排的分化过程，涉及胎儿 - 母体界面的所有细胞成分。滋养层细胞与蜕膜之间异常的相互作用会导致流产以及妊娠后期出现的疾病，包括先兆子痫、胎儿宫内生长受限和早产。针对广泛物种的着床和胎盘形成调节进行了大量研究。然而，在滋养层细胞分化以及蜕膜特异性基因表达和调控方面存在显著的物种差异。大部分相关信息来自使用小鼠模型的研究。由于新兴的先进技术，直到最近才对人类着床和胎盘形成的生理学和病理学有了全面的了解。随着人类滋养层干细胞的衍生、3D 类器官培养以及分化细胞的单细胞分析，产生了细胞类型特异性转录谱和功能，并且每种都表现出独特的特征。此外，通过整合转录组信息，研究人员可以揭示植入前胚胎和早期病理性胎盘中胚胎和胎盘细胞的细胞功能障碍。事实上，胎儿 - 母体细胞转运的临床应用已用于非整倍体的无创产前诊断和妊娠并发症的预测。此外，最近的研究为针对胎盘功能障碍和疾病的富含胎盘分子的治疗策略的开发提出了一条可行的途径。
