Markers of epithelial-mesenchymal transformation in placentas with fetal growth retardation

Abstract

Objective of the study: to study the phenomenon of epithelial-mesenchymal transformation in the placenta with fetal growth retardation (FGR).
Materials and methods. A study of placentas from 40 singleton births with FGR, divided into 4 groups, was conducted. Group I included pregnant women with FGR diagnosed before 32 weeks without concomitant gestational complications, group II included patients with FGR diagnosed up to 32 weeks and preeclampsia criteria, group III included pregnant women with FGR diagnosed after 32 weeks without concomitant gestational complications, group IV included pregnant women with FGR diagnosed after 32 weeks and concomitant preeclampsia. The control group consisted of 10 healthy parturient women.
The intensity of cytokeratin 7 and vimentin expression in extravillous and villous trophoblast cells and amnion was determined by an immunohistochemical direct immunoperoxidase method using microscopic morphometry in placental samples.
Results. In the extravillous trophoblast of the placenta against the background of FGR and preeclampsia and isolated early fetal growth retardation, increased expression of cytokeratin 7 was recorded: 0.471 standard units (SI) of light in group I, 0.437 SI of light in group II, 0.424 SI of light in group IV, 0.345 SI of light in the control group. At the same time, in the villous trophoblast, against the background of isolated FGR, a reduced expression of cytokeratin 7 was recorded: 0.345 SI of light in group I and 0.357 in group III versus 0.498 SI of light in the control group, and for concomitant preeclampsia even lower – 0.248 SI of light in group II and 0.239 SIof light in group IV.
Vimentin expression in extravillous trophoblast in FGR and preeclampsia, as well as in isolated early FGR, was lower than in the control group – 0.271 SI of light in group I, 0.237 SI of light in group II, 0.224 SI of light in group IV and 0.345 SI of light in healthy placentas. In villous trophoblast, vimentin expression was higher in placentas with FGR (0.375 SI of light in group I, 0.348 SI of light in group II, 0.387 SI of light in group III and 0.339 SI of light in group IV) than in healthy placentas (0.248 SI of light).
Conclusions. In the extravillous trophoblast of placentas with FGR and preeclampsia, as well as with isolated early FGR, insufficient acquisition of mesenchymal properties by cells (insufficient expression of vimentin) and preservation of epithelial properties (increased expression of cytokeratin 7) are observed. In the villous trophoblast of placentas with isolated FGR, excessive acquisition of mesenchymal cells and loss of epithelial properties were detected, and in the presence of concomitant preeclampsia, these changes are even more pronounced.