Marco Aurora De, Cazzato Gerardo, Maggialetti Rosalba, Ingravallo Giuseppe, Fanelli Margherita, Vimercati Antonella, Cicinelli Ettore, Laforgia Nicola, Neri Iria, Bonifazi Ernesto, Bonamonte Domenico
Section of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area, University "Aldo Moro" of Bari, 70121 Bari, Italy.
Section of Pathology, Department of Precision and Regenerative Medicine and Jonian Area, University "Aldo Moro" of Bari, 70121 Bari, Italy.
Dermatopathology (Basel). 2024 Jul 11;11(3):192-199. doi: 10.3390/dermatopathology11030020.
ACE2 is a mono-carboxypeptidase with remarkable vasculo-protective properties, and its expression in the human placenta plays a central role in blood pressure homeostasis and fetal perfusion. Therefore, an alteration in the placental expression of ACE2 could be responsible for reduced placental perfusion and infantile hemangioma (IH) development. Study placentae were collected from patients affected by IHs who were referred to our Dermatology Clinic from 2016 to 2022, while control placentae were randomly collected while matching cases for gestational age. Immunohistochemical investigations were performed with a recombinant anti-ACE2 rabbit monoclonal antibody. A total of 47 placentae were examined, including 20 study placentae and 27 control ones. The mean placental weight was significantly lower in the study group (380.6 g vs. 502.3 g; = 0.005), while subclinical chorioamnionitis occurred more frequently in the study group (20% vs. 0%, = 0.03). The mean ACE2 expression was dramatically lower in the study group (χ2 = 42.1 < 0.001), and the mean placental weight was significantly lower when ACE2 was not expressed compared to the 25-75% and >75% classes of expression ( < 0.05). This study demonstrated that ACE2, as a marker for tissue hypoxia, is dramatically hypo-expressed in placentae belonging to mothers who delivered one or more babies with IH compared to the controls.
血管紧张素转换酶2（ACE2）是一种具有显著血管保护特性的单羧肽酶，其在人胎盘中的表达在血压稳态和胎儿灌注中起着核心作用。因此，ACE2在胎盘表达的改变可能是胎盘灌注减少和婴儿血管瘤（IH）发生的原因。研究胎盘取自2016年至2022年转诊至我们皮肤科诊所的患有IH的患者，而对照胎盘是在匹配孕周的情况下随机收集的。使用重组抗ACE2兔单克隆抗体进行免疫组织化学研究。共检查了47个胎盘，包括20个研究胎盘和27个对照胎盘。研究组的平均胎盘重量显著较低（380.6克对502.3克；P = 0.005），而研究组亚临床绒毛膜羊膜炎的发生率更高（20%对0%，P = 0.03）。研究组的平均ACE2表达显著降低（χ2 = 42.1，P < 0.001），与ACE2表达处于25%-75%和>75%类别时相比，当ACE2不表达时平均胎盘重量显著更低（P < 0.05）。本研究表明，与对照组相比，作为组织缺氧标志物的ACE2在分娩一个或多个患有IH婴儿的母亲的胎盘中显著低表达。
