Read full article
Authors: Voicu Daşcău1, Cristina Onel1, Iman Ait El Haj2,Maria Puşchiţa3
Affiliation: 1Department of Obstetrics and Gynecalogy, „Vasile Goldiş” Western University, Arad, Romania
2Department of Obstetrics and Gynecalogy, Clinical Emergency County Hospital, Arad, Romania
3Department of Internal Medicine, „Vasile Goldiş” Western University, Arad, Romania
Abstract: Placentation is a complex spatial and temporal process, involving manu local and general factors, both placental and maternal. The vasculogenesis of the placenta is evident after 21 days of amenorrhea and ends at 10 weeks. Trophoblastic invasion, ranging from 8 to 18 weeks, has two spatial pathways, interstitial and endovascular. During the second trimester, the second stage of endovascular trophoblastic invasion extends into the lumen of spiraling arteries deeper in the myometrium, and the vessels turn into dilated vessels with thin walls, which are passive pathways for increased uteroplacental blood flow from pregnancy. This process is guided and controlled by enzymes, proliferation markers, adhesion molecules, extracellular matrix degradation, oxygen tension, immunological factors, insulin-like growth factor, placental fibroblasts and placental macrophages, vasoactive factors, and angiogenic factors.
Keywords: placenta, trophoblast, pregnancy, endometrium, decidua
References: Ahmed, A., Li, X. F., Dunk, C., et al. (1995). Co-localizationof vascular endothelial growth factor and its Flt-1 receptor in human placenta. Growth Factors, 12, 235–43.
Alberts, B., Bray, D., Lewis, J., Raff, M., Roberts, K. and Watson, J. (1994). Molecular Biology of the Cell. New York: Garland Publishing Inc.
Alberts, B., Bray, D., Lewis, J., Raff, M., Roberts, K. and Watson, J. (1994). Molecular Biology of the Cell. New York: Garland Publishing Inc.
Alexander, C. and Werb, Z. (1991). Extracellular matrix degradation. In Cell Biology of the Extracellular Matrix, ed. E. Hay. New York: Plenum Press, pp. 255_302.
American College of Obstetricians & Gynecologists Technical Bulletin. Int J Gynecol Obstet 1996;53:175–183
American College of Obstetricians and Gynecologists: Diagnosis and management of preeclampsia and eclampsia. ACOG Practice Bulletin No. 33. Obstet Gynecol 2002;99:159.
Aplin, J. D. (1993). Expression of integrin a6b4 in human trophoblast and its loss from extravillous cells. Placenta, 14, 203_15.
Ashton, S. V., Whitley, G. StJ., Dash, P. R., Wareing, M., Crocker, I. P., Baker, P. N. and Cartwright, J. E. (2005). Uterine spiral artery remodeling involves endothelial apoptosis induced by extravillous trophoblasts through Fas/FasL interactions. Arterioscler. Thromb. Vasc. Biol., 25, 102_8.
Birk, D. E., Silver, F. H. and Trelstad, R. L. (1991). Matrix assembly. In Cell Biology of Extracellular Matrix, ed. E. Hay. New York: Plenum Press, pp. 221_54.
Brunori IDL, Battini L, Simonelli M, et al. Increased HLA-DR homozygosity associated with pre-eclampsia. Hum Reprod 2000; 15:1807–12
Caniggia, I., Grisaru-Gravnosky, S., Kuliszewsky, M., Post, M. and Lye, S. J. (1999). Inhibition of TGFBb3 restores the invasive capability of extravillous trophoblasts in preeclamptic pregnancies. J. Clin. Invest., 103, 1641_50.
Caniggia, I., Mostachfi, H., Winter, J., et al. (2000a) Hypoxia-inducible factor-1 mediates the biological effects of oxygen on human trophoblast differentiation through TGF-b3. J. Clin. Invest., 105, 577_87.
Caniggia, I., Winter, J., Lye, S. J. and Post, M. (2000b). Oxygen and placental development during the first trimester: implications for the pathophysiology of preeclampsia. Placenta, 21, S25_30.
Castellucci, M., Classen-Linke, I., Munlhauser, J.,Kaufmann, P., Zardi, L. and Chiquet-Ehrismann, R. (1991). The human placenta: a model for tenascin expression. ImmunoHistochem., 95, 449_58.
Chambers JC et al: Association of maternal endothelial dysfunction with preeclampsia. JAMA 2001;285:1607. [PMID: 11268269]
Crossey PA, Pillai CC, Miell JP. Altered placental development and intrauterine growth restriction in IGF binding protein-1 transgenic mice. J Clin Invest 2002; 110:411–18
Damsky, C. H., Fitzgerald, M. L. and Fisher, S. J. (1992). Distribution patterns of extracellular matrix components and adhesion receptors are intricately modulated during first trimester cytotrophoblast differentiation along the invasive pathway, in vivo. J. Clin. Invest., 89, 210_22.
Davison, J. M. (1984). Renal haemodynamics and volume homeostasis in pregnancy. Scand. J. Clin. Lab. Invest., 169(Suppl.), 15–27.
Duley L: Pre-eclampsia and hypertension. Clin Evid 2002;7:1296. [PMID: 12230748]
Dunk, C. and Ahmed, A. (2001). Expression of VEGF-c and activation of its receptors VEGFR-2 and VEGFR-3 in trophoblast. Histol. Histopathol., 16, 359–75.
Esplin MS et al: Paternal and maternal components of the predisposition to preeclampsia. N Engl J Med 2001;344:867. [PMID: 11259719]
Garcia-Lloret, M. I., Morrish, D. W., Wegmann, T. G., Honore, L., Turner, A. R. and Guilbert, L. J. (1994). Demonstration of functional cytokine-placental interactions: CSF-1 and GM-CSF stimulate human cytotrophoblast differentiation and peptide hormone secretion. Exp. Cell Res., 214, 46_54.
Graham CH, McCrae KR. Altered expression of gelatinase and surfaceassociated plasminogen activator activity by trophoblast cells isolated from placentas of preeclamptic patients. Am J Obstet Gynecol 1996; 175:555–62
Hustin, J., Foidart, J. M. and Lambotte, R. (1983). Maternal vascular lesions in pre-eclampsia and intrauterine growth retardation: light microscopy and immunofluorescence. Placenta, 4, 489_98.
Jauniaux, E., Watson, A. L., Hempstock, J., Bao, Y. P., Skepper, J. N. and Burton, G. J. (2000). Onset of maternal arterial blood flow and placental oxidative stress. A possible factor in human early pregnancy failure. Am. J. Pathol., 157(6), 2111_22.
Karumanchi A, Rana S, Taylor RN: Angiogenesis and preeclampsia. In Taylor RN, Roberts JM, Cunningham FG (eds): Chesley’s Hypertensive Disorders in Pregnancy, 4th ed. Amsterdam, Academic Press, 2014
Khan, S., Katabuchi, H., Araki, M., Nishimura, R. and Okamura, H. (2000). Human villous macrophageconditioned media enhance human trophoblast growth and differentiation in vitro. Biol. Reprod., 62, 1075_83.
Khan, S., Katabuchi, H., Araki, M., Nishimura, R. and Okamura, H. (2000). Human villous macrophageconditioned media enhance human trophoblast growth and differentiation in vitro. Biol. Reprod., 62, 1075_83.
Kilpatrick D, Gibson F, Livingston J, Listen W. Pre-eclampsia is associated with HLA-DR4 sharing between mother and fetus. Tissue Antigens 1990; 35:178–81
Korhonen, M., Ylanne, J., Laitnen, L., Cooper, H. N.,Quaranta, V. and Virtanenen, I. (1991). Distribution of the a1_a6 integrin subunits in human developing and term placenta. Lab. Invest., 65, 347_56.
Kosanke, G. (1994). Proliferation, Wachstum und Differenzierung der Zottenba¨ume der menschlichen Placenta. Aachen: Verlag Shaker.
Kreis, T. and Vale, R. (1993). Guidebook to the Extracellular Matrix and Adhesion Proteins. Oxford: Oxford University Press.
Lain KY, Roberts JM: Contemporary concepts in the pathogenesis and management of preeclampsia. JAMA 2002;287:3183. [PMID: 12076198]
Lala, P. K. and Hamilton, G. S. (1996). Growth factors, proteases and protease inhibitors in the maternal_fetal dialogue. Placenta, 17, 545_55.
Le Gal FA, Riteau B, Sedlik C, et al. HLA-G-mediated inhibition of antigenspecific cytotoxic T lymphocytes. Int Immunol 1999; 11:1351–6
Leiper, J. and Vallance, P. (1999). Biological significance of endogenous methylarginines that inhibit nitric oxide synthases. Cardiovasc. Res., 43, 542–8.
Lyall, F. (2003). Development of the uteroplacental circulation: the role of carbon monoxide and nitric oxide in trophoblast invasion and spiral artery transformation. Microscop. Res. Tech., 60, 402_11.
Lyall, F., Barber, A., Myatt, L., Bulmer, J. N. and RobsonS. C. (2000). Hemeoxygenase expression in human placenta and placental bed implies a role in regulation of trophoblast invasion and placental function. FASEB J., 14, 208_19.
McMaster MT, Librach CL, Zhou Y, et al. Human placental HLA-G expression is restricted to differentiated cytotrophoblasts. J Immunol 1995; 154:3771–8
Molnar, M. and Hertelendy, F. (1995). Signal transduction in rat myometrial cells: comparison of the actions of endothelin-1, oxytocin and prostaglandin F2 alpha. Eur. J. Endocrinol., 133, 467–74.
Mu¨hlhauser, J., Crescimanno, C., Kaufmann, P., Ho¨fler, H., Zaccheo, D. and Castellucci, M. (1993). Differentiation and proliferation patterns in human trophoblast revealed by c-erbB-2 oncogene product and EGR-R. J. Histochem. Cytochem., 41, 165_73.
Pijnenborg R, Bland JM, Robertson WB, Brosens I. Uteroplacental arterial changes related to interstitial trophoblast migration in early human pregnancy. Placenta 1983; 4:397–413
Pijnenborg, R., Bland, J. M., Robertson, W. B. and Brosens, I. (1983). Uteroplacental arterial changes related to interstitial trophoblast migration in early human pregnancy. Placenta, 4, 397_414.
Pijnenborg, R., Bland, J. M., Robertson, W. B., Dixon, G. and Brosens, I. (1981). The pattern of interstitial trophoblastic invasion of the myometrium in early human pregnancy. Placenta, 2, 303_16.
Pijnenborg, R., D’Hooghe, T., Vercruysse, L. and Bambra, C. (1996). Evaluation of trophoblast invasion in placental bed biopsies of the baboon, with immunohistochemical localisation of cytokeratin, fibronectin, and laminin. J. Med. Primatol., 25, 272_81.
Pijnenborg, R., Dixon, G., Robertson, W. B. and Brosens, I. (1980). Trophoblastic invasion of human decidua from 8 to 18 weeks of pregnancy. Placenta, 1, 3_19.
Pijnenborg, R., Vercruysse, L. and Hanssens, M. (2006). The uterine spiral arteries in human pregnancy: facts and controversies. Placenta, 27, 939_58.
Raijmakers, M. T. M., Steegers, E. A. P. and Peters, W. H. M. (2001a). Glutathione S-transferases and thiol concentrations in embryonic and early fetal tissues. Hum. Reprod., 16(11), 2445_50.
Robson, S. C., Hunter, S., Boys, R. J. and Dunlop, W. (1989). Serial study of factors influencing changes in cardiac output during human pregnancy. Am. J. Physiol., 256, H1060–5.
Rodesch, F., Simon, P., Donner, C. and Jauniaux, E. (1992). Oxygen measurements in endometrial and trophoblastic tissues during early pregnancy. Obstet. Gynecol., 80, 283_5.
Russell, K. R., Haynes, M. P., Sinha, D., et al. (2000a). Human vascular endothelial cells contain membrane binding sites for estradiol, which mediate rapid intracellular signalling. Proc. Natl Acad. Sci. USA, 97, 5930–5.
Savvidou, M. D., Kametas, N. A., Donald, A. E. and Nicolaides, K. H. (2000). Non-invasive assessment of endothelial function in normal pregnancy. Ultrasound Obstet. Gynecol., 15, 502–7.
Schneider MM, Landau R, Mörtl MM. New insights in hypertensive disorders of pregnancy. In: Obstetric & Gynecologic Anaesthesia: Baillere’s Best Practice & Research. London: Lippincott Williams & Wilkins, 2001:291–297.
Sibai BM et al: Risk factors associated with preeclampsia in healthy nulliparous women. The Calcium for Preeclampsia Prevention (CPEP) Study Group. Am J Obstet Gynecol 1997;177:1003. [PMID: 9396883]
Soothill, P. W., Nicolaides, K. H., Rodeck, C. H. and Campbell, S. (1986). Effect of gestational age on fetal and intervillous blood gas and acid_base values in human pregnancy. Fetal Ther., 1, 168_75.
Vallance, P., Leone, A., Calver, A., Collier, J. and Moncada, S. (1992). Accumulation of an endogenous inhibitor of nitric oxide synthesis in chronic renal failure. Lancet, 339, 572–5.
Verma, A., Hirsch, D. J., Glatt, C. E., Ronnett, G. V. an Snyder, S. H. (1993). Carbon monoxide: a putative neural messenger. Science, 259, 381.
Wetzka, B., Clark, D. E., Charnock-Jones, D. S., Zahradnik, H. P. and Smith, S. K. (1997). Isolation of macrophages (Hofbauer cells) from human term placenta and their prostaglandin E2 and thromboxane production. Hum. Reprod., 12, 847_52.
Zakhary, R., Gaine, S. P., Dinerman, J. L., Ruat, M., Flavahan, N. A. and Snyder, S. H. (1996). Hemeoxygenase 2: endothelial and neuronal localization and role in endothelium-dependent relaxation. Proc. Natl Acad. Sci. USA, 93, 795_8.
Zhou Y, Fisher SJ, Janatpour M, et al. Human cytotrophoblasts adopt a vascular phenotype as they differentiate. A strategy for successful endovascular invasion? J Clin Invest 1997; 99:2139–51
Zhou, Y., McMater, M., Woo, K., et al. (2002). Vascular endothelial growth factor ligands and receptors that regulate human cytotrophoblast survival are dysregulated in severe pre-eclampsia and haemolysis, elevated