Wu Qiongwei, Fan Jiao, Sheng Qingjing, He Xiaoying
Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200120, P.R. China.
Biomed Rep. 2025 Jun 26;23(3):148. doi: 10.3892/br.2025.2026. eCollection 2025 Sep.
In the present study, it was investigated whether gestational trophoblast localization at the cesarean scar was associated with increased monocyte chemoattractant protein-1 (MCP-1) and cholesterol synthesis in women's blood and decidual stromal cells. Patients who underwent abortion at 6-10 weeks of gestation were divided into three groups: cesarean scar pregnancy (CSP), normal intrauterine pregnancy without history of cesarean section (NP), and normal intrauterine pregnancy after cesarean section (NPACS). Blood and decidual tissue at the localization of the gestational sacs were collected from the patients, and RNA sequencing, PCR and ELISA were used to detect differences in the expression of thrombin receptor protease-activated receptor-1 (PAR-1), MCP-1, CCR2, chemokine (C-C motif) receptor 2 (CCR2) and cholesterol synthesis-related proteins sterol regulatory element-binding protein 2 (SREBP2), 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) and hydroxy-methyl-glutaryl Coenzyme A synthase (HMGCS). The expression of PAR-1, MCP-1, CCR2, SREBP2, HMGCR and HMGCS in the blood and the decidual stromal cells at the localization of the gestational sac was significantly higher in women with CSP than in the other two groups of patients, whereas the expression of these molecules between NP group and NPACS were not significantly different, and the total blood cholesterol levels of women with cesarean scar pregnancies were significantly higher than those of the other two groups. The development of CSP was associated with a high cholesterol environment and increased MCP-1 expression in women.
在本研究中，调查了剖宫产瘢痕处的妊娠滋养细胞定位是否与女性血液和蜕膜基质细胞中单核细胞趋化蛋白-1（MCP-1）及胆固醇合成增加相关。将妊娠6-10周行人工流产的患者分为三组：剖宫产瘢痕妊娠（CSP）组、无剖宫产史的正常宫内妊娠（NP）组和剖宫产术后正常宫内妊娠（NPACS）组。收集患者妊娠囊定位处的血液和蜕膜组织，采用RNA测序、PCR及ELISA检测凝血酶受体蛋白酶激活受体-1（PAR-1）、MCP-1、趋化因子（C-C基序）受体2（CCR2）以及胆固醇合成相关蛋白固醇调节元件结合蛋白2（SREBP2）、3-羟基-3-甲基戊二酰辅酶A还原酶（HMGCR）和羟甲基戊二酰辅酶A合酶（HMGCS）表达的差异。CSP组女性妊娠囊定位处血液及蜕膜基质细胞中PAR-1、MCP-1、CCR2、SREBP2、HMGCR及HMGCS的表达显著高于其他两组患者，而NP组与NPACS组之间这些分子的表达无显著差异，且剖宫产瘢痕妊娠女性的总血胆固醇水平显著高于其他两组。CSP的发生与女性体内高胆固醇环境及MCP-1表达增加有关。
