Abnormal placental CD8
endothelial cells
fibrin
image analysis
leukocytes
pathologist scoring
pregnancy complication
small-for-gestational age
stereology
villitis of unknown aetiology
villous tissue
Journal
The Journal of physiology
ISSN: 1469-7793
Titre abrégé: J Physiol
Pays: England
ID NLM: 0266262
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
31
01
2020
accepted:
28
08
2020
pubmed:
5
9
2020
medline:
2
3
2021
entrez:
4
9
2020
Statut:
ppublish
Résumé
Placental pathological abnormalities are more frequently observed in complicated pregnancies than in healthy pregnancies. Infiltration of CD8 Fetal growth restriction (FGR) and pre-eclampsia are severe, adverse pregnancy outcomes. Alterations in placental histology are frequently reported in these pregnancy complications and are often based upon scoring by pathologists. However, many alterations are also observed in placenta from uncomplicated pregnancies. Moreover, knowledge of disease state may bias assessment. We sought to perform an objective comparison of placental microscopic appearance in normal and complicated pregnancies. Placental villous tissue (n = 823) and edge biopsies (n = 488) from 871 individual, singleton pregnancies were collected after delivery. Cases of small-for-gestational age (SGA) or pre-eclampsia were matched with healthy controls. A subset of the SGA cases displayed signs of FGR. Cases of preterm delivery were also included. Tissue sections were stained with haematoxylin and eosin or antibodies for CD8, CD14, CD31, CD79α and elastase. Images were scored by two experienced pathologists for pathological features or analysed by image analysis and stereology. Analyses were performed blind to case-control status and gestational age. Volume fraction of T-cells increased in placentas from pregnancies complicated by pre-eclampsia (adjusted odds ratio (aOR) 1.46, 95% CI: 1.12-1.90) and FGR (aOR 1.64, 95% CI: 1.11-2.43), whereas B-cells only increased in FGR (aOR 1.65, 95% CI: 1.05-2.60). Pathological abnormalities in villous tissue were reported in 21.4% (88/411) of complicated pregnancies and 14.3% (52/363) of controls (OR 1.62, 95% CI: 1.12-2.37). There were no differences in the fractions of endothelial cells, fibrin deposition, macrophages and neutrophils when comparing normal and complicated pregnancies. In conclusion, FGR and pre-eclampsia are associated with T-cell infiltration of the placenta and placental pathological abnormalities.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
5555-5571Subventions
Organisme : Medical Research Council
ID : MR/K021133/1
Pays : United Kingdom
Informations de copyright
© 2020 The Authors. The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.
Références
ACOG (2013). Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol 122, 1122-1131.
Bartha JL & Comino-Delgado R (1999). Lymphocyte subpopulations in intrauterine growth retardation in women with or without previous pregnancies. Eur J Obstet Gynecol Reprod Biol 82, 23-27.
Burton GJ & Jauniaux E (2018). Pathophysiology of placental-derived fetal growth restriction. Am J Obstet Gynecol 218, S745-S761.
Burton GJ & Jones CJ (2009). Syncytial knots, sprouts, apoptosis, and trophoblast deportation from the human placenta. Taiwan J Obstet Gynecol 48, 28-37.
Burton GJ, Redman CW, Roberts JM & Moffett A (2019). Pre-eclampsia: pathophysiology and clinical implications. BMJ 366, l2381.
Chamley LW, Chen Q, Ding J, Stone PR & Abumaree M (2011). Trophoblast deportation: just a waste disposal system or antigen sharing? J Reprod Immunol 88, 99-105.
Cleaton MA, Dent CL, Howard M, Corish JA, Gutteridge I, Sovio U, Gaccioli F, Takahashi N, Bauer SR, Charnock-Jones DS, Powell TL, Smith GC, Ferguson-Smith AC & Charalambous M (2016). Fetus-derived DLK1 is required for maternal metabolic adaptations to pregnancy and is associated with fetal growth restriction. Nat Genet 48, 1473-1480.
de Goffau MC, Lager S, Sovio U, Gaccioli F, Cook E, Peacock SJ, Parkhill J, Charnock-Jones DS & Smith GCS (2019). Human placenta has no microbiome but can contain potential pathogens. Nature 572, 329-334.
Devisme L, Chauviere C, Franquet-Ansart H, Chudzinski A, Stichelbout M, Houfflin-Debarge V & Subtil D (2017). Perinatal outcome of placental massive perivillous fibrin deposition: a case-control study. Prenat Diagn 37, 323-328.
Egbor M, Ansari T, Morris N, Green CJ & Sibbons PD (2006). Morphometric placental villous and vascular abnormalities in early- and late-onset pre-eclampsia with and without fetal growth restriction. BJOG 113, 580-589.
Ernst LM (2018). Maternal vascular malperfusion of the placental bed. APMIS 126, 551-560.
Gaccioli F, Lager S, Sovio U, Charnock-Jones DS & Smith GCS (2017). The pregnancy outcome prediction (POP) study: investigating the relationship between serial prenatal ultrasonography, biomarkers, placental phenotype and adverse pregnancy outcomes. Placenta 59, S17-S25.
Gardosi J, Mongelli M, Wilcox M & Chang A (1995). An adjustable fetal weight standard. Ultrasound Obstet Gynecol 6, 168-174.
Hendrix MLE, Bons JAP, Alers NO, Severens-Rijvers CAH, Spaanderman MEA & Al-Nasiry S (2019). Maternal vascular malformation in the placenta is an indicator for fetal growth restriction irrespective of neonatal birthweight. Placenta 87, 8-15.
Ietta F, Wu Y, Romagnoli R, Soleymanlou N, Orsini B, Zamudio S, Paulesu L & Caniggia I (2007). Oxygen regulation of macrophage migration inhibitory factor in human placenta. Am J Physiol Endocrinol Metab 292, E272-E280.
Kim CJ, Romero R, Chaemsaithong P & Kim JS (2015). Chronic inflammation of the placenta: definition, classification, pathogenesis, and clinical significance. Am J Obstet Gynecol 213, S53-S69.
Kim JS, Romero R, Kim MR, Kim YM, Friel L, Espinoza J & Kim CJ (2008). Involvement of Hofbauer cells and maternal T cells in villitis of unknown aetiology. Histopathology 52, 457-464.
Lager S, de Goffau MC, Sovio U, Peacock SJ, Parkhill J, Charnock-Jones DS & Smith GCS (2018). Detecting eukaryotic microbiota with single-cell sensitivity in human tissue. Microbiome 6, 151.
Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, Lalli M, Bhutta Z, Barros AJ, Christian P, Mathers C & Cousens SN; Lancet Every Newborn Study Group (2014). Every Newborn: progress, priorities, and potential beyond survival. Lancet 384, 189-205.
Mayadas TN, Cullere X & Lowell CA (2014). The multifaceted functions of neutrophils. Annu Rev Pathol 9, 181-218.
Mayhew TM (2009). A stereological perspective on placental morphology in normal and complicated pregnancies. J Anat 215, 77-90.
Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, de Groot CJM & Hofmeyr GJ (2016). Pre-eclampsia. Lancet 387, 999-1011.
Noble M, McLennan D, Wilkinson K, Whitworth A, Barnes H & Dibben C (2008). The English Indices of Deprivation 2007. Department for Communities and Local Government, London.
Pasupathy D, Dacey A, Cook E, Charnock-Jones DS, White IR & Smith GC (2008). Study protocol. A prospective cohort study of unselected primiparous women: the pregnancy outcome prediction study. BMC Pregnancy Childbirth 8, 51.
Pathak S, Lees CC, Hackett G, Jessop F & Sebire NJ (2011). Frequency and clinical significance of placental histological lesions in an unselected population at or near term. Virchows Arch 459, 565-572.
Pearce N (2016). Analysis of matched case-control studies. BMJ 352, i969.
Pique-Regi R, Romero R, Tarca AL, Sendler ED, Xu Y, Garcia-Flores V, Leng Y, Luca F, Hassan SS & Gomez-Lopez N (2019). Single cell transcriptional signatures of the human placenta in term and preterm parturition. Elife 8, e52004.
Redline RW (2015). Classification of placental lesions. Am J Obstet Gynecol 213, S21-S28.
Redline RW & Patterson P (1993). Villitis of unknown etiology is associated with major infiltration of fetal tissue by maternal inflammatory cells. Am J Pathol 143, 473-479.
Salam RA, Das JK & Bhutta ZA (2014). Impact of intrauterine growth restriction on long-term health. Curr Opin Clin Nutr Metab Care 17, 249-254.
Say L, Chou D, Gemmill A, Tuncalp O, Moller AB, Daniels J, Gulmezoglu AM, Temmerman M & Alkema L (2014). Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2, e323-e333.
Shah PS, Zao J & Ali S; Knowledge Synthesis Group of Determinants of preterm/LBW births (2011). Maternal marital status and birth outcomes: a systematic review and meta-analyses. Matern Child Health J 15, 1097-1109.
Solders M, Gorchs L, Tiblad E, Gidlof S, Leeansyah E, Dias J, Sandberg JK, Magalhaes I, Lundell AC & Kaipe H (2019a). Recruitment of MAIT cells to the intervillous space of the placenta by placenta-derived chemokines. Front Immunol 10, 1300.
Solders M, Lundell AC, Gorchs L, Gidlof S, Tiblad E & Kaipe H (2019b). Mature naive B cells are retained in the placental intervillous blood and positively associate with specific chemokines in full-term healthy pregnancy. Am J Reprod Immunol 82, e13154.
Sovio U, White IR, Dacey A, Pasupathy D & Smith GCS (2015). Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study. Lancet 386, 2089-2097.
Turowski G & Vogel M (2018). Re-view and view on maturation disorders in the placenta. APMIS 126, 602-612.
Vento-Tormo R, Efremova M, Botting RA, Turco MY, Vento-Tormo M, Meyer KB, Park JE, Stephenson E, Polanski K, Goncalves A, Gardner L, Holmqvist S, Henriksson J, Zou A, Sharkey AM, Millar B, Innes B, Wood L, Wilbrey-Clark A, Payne RP, Ivarsson MA, Lisgo S, Filby A, Rowitch DH, Bulmer JN, Wright GJ, Stubbington MJT, Haniffa M, Moffett A & Teichmann SA (2018). Single-cell reconstruction of the early maternal-fetal interface in humans. Nature 563, 347-353.
Wright E, Audette MC, Ye XY, Keating S, Hoffman B, Lye SJ, Shah PS & Kingdom JC (2017). Maternal vascular malperfusion and adverse perinatal outcomes in low-risk nulliparous women. Obstet Gynecol 130, 1112-1120.
Xiong F, Tong Y, You Y, Li P, Huo T, Tu W & Mao M (2012). Prospective cohort study about the lymphocyte subpopulations' change and impact on the pregnancy outcome in fetal growth restriction. J Matern Fetal Neonatal Med 25, 2773-2777.
Zhao L, Xia J, Wang X & Xu F (2014). Transcriptional regulation of CCL20 expression. Microbes Infect 16, 864-870.