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Transcription factors active in embryonic parathyroid cells can be maintained in adult parathyroids and be involved in tumorigenesis. TBX1, the candidate gene of 22q11.2-DiGeorge syndrome, which includes congenital hypoparathyroidism, is involved in parathyroid embryogenesis. The study aimed to investigate expression, function, and regulation of the parathyroid embryonic transcription factor TBX1 in human parathyroid adult normal and tumor tissues. TBX1 transcripts were detected in normal parathyroids and were deregulated in parathyroid tumors. Using immunohistochemistry, TBX1 protein was detected, mainly at the nuclear level, in a consistent proportion of cells in normal adult parathyroids, whereas TBX1 immunoreactivity was absent in fetal parathyroids. TBX1-expressing cells were markedly reduced in about a half of adenomas (PAds) and two-thirds of carcinomas and the proportion of TBX1-expressing cells negatively correlated with the serum albumin-corrected calcium levels in the analyzed tumors. Moreover, a subset of TBX1-expressing tumor cells coexpressed PTH. TBX1 silencing in HEK293 cells, expressing endogenous TBX1, increased the proportion of cells in the G0/G1 phase of cell cycle; concomitantly, CDKN1A/p21 and CDKN2A/p16 transcripts increased and ID1 mRNA levels decreased. TBX1 silencing exerted similar effects in PAd-derived cells, suggesting cell cycle arrest. Moreover, in PAd-derived cells GCM2 and PTH mRNA levels were unaffected by TBX1 deficiency, whereas it was associated with reduction of WNT5A, an antagonist of canonical WNT/ß-catenin pathway. WNT/ß-catenin activation by lithium chloride inhibited TBX1 expression levels both in HEK293 and PAd-derived cells. In conclusion, TBX1 is expressed in adult parathyroid cells and deregulated in parathyroid tumors, where TBX1 deficiency may potentially contribute to the low proliferative nature of parathyroid tumors.
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Glándulas Paratiroides/metabolismo , Neoplasias de las Paratiroides/metabolismo , Proteínas de Dominio T Box , Ciclo Celular , Femenino , Feto , Silenciador del Gen , Células HEK293 , Humanos , Masculino , Persona de Mediana Edad , Proteínas de Dominio T Box/genética , Proteínas de Dominio T Box/metabolismo , Proteínas de Dominio T Box/fisiologíaRESUMEN
BACKGROUND: CA19.9 antigen has been assumed as an abundant product of cancer cells, due to the reactivity found by immunohistochemical staining of cancer tissues with anti-CA19.9 antibody. METHODS: Expression and biosynthesis of type 1 chain Lewis antigens in the colon and the pancreas were studied by immunodetection in tissue sections and lysates, quantification of glycosyltransferase transcripts, bisulfite sequencing, and chromatin immunoprecipitation assays. RESULTS: CA19.9 was poorly detectable in normal colon mucosa and almost undetectable in colon cancer, while it was easily detected in the pancreatic ducts, together with Lewis b antigen, under both normal and cancer conditions. B3GALT5 transcripts were down-regulated in colon cancer, while they remained expressed in pancreatic cancer. Even ST3GAL3 transcript appeared well expressed in the pancreas but poorly in the colon, irrespective of normal or cancer conditions. CpG islands flanking B3GALT5 native promoter presented an extremely low degree of methylation in pancreatic cancer with respect to colon cancer. In a DNA region about 1kb away from the B3GALT5 retroviral promoter, a stretch of CG dinucleotides presented a methylation pattern potentially associated with transcription. Such a DNA region and the transcription factor binding site provided overlapping results by chromatin immunoprecipitation assays, corroborating the hypothesis. CONCLUSIONS: CA19.9 appears as a physiological product whose synthesis strongly depends on the tissue specific and epigenetically-regulated expression of B3GALT5 and ST3GAL3. GENERAL SIGNIFICANCE: CA19.9 and other Lewis antigens acquire tumor marker properties in the pancreas due to mechanisms giving rise to reabsorption into vessels and elevation in circulating levels.
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Antígenos de Neoplasias/metabolismo , Antígeno CA-19-9/metabolismo , Neoplasias del Colon/metabolismo , Galactosiltransferasas/metabolismo , Glicosiltransferasas/metabolismo , Antígenos del Grupo Sanguíneo de Lewis/metabolismo , Neoplasias Pancreáticas/metabolismo , Sialiltransferasas/metabolismo , Línea Celular Tumoral , Inmunoprecipitación de Cromatina , Colon/metabolismo , Colon/patología , Neoplasias del Colon/patología , Islas de CpG/genética , ADN/genética , Metilación de ADN/genética , Epigénesis Genética , Técnica del Anticuerpo Fluorescente , Regulación Enzimológica de la Expresión Génica , Humanos , Páncreas/metabolismo , Páncreas/patología , Neoplasias Pancreáticas/patología , Regiones Promotoras Genéticas , ARN Mensajero/genética , ARN Mensajero/metabolismo , beta-Galactosida alfa-2,3-SialiltransferasaAsunto(s)
Cordón Nucal , Mortinato , África del Sur del Sahara , Femenino , Humanos , Modelos Teóricos , Complicaciones del Trabajo de Parto , EmbarazoRESUMEN
OBJECTIVE: In recent decades, the trend for women is to delay childbearing. However, worldwide, advanced maternal age is an independent risk factor for stillbirth, as well as advanced gestational age. National data are not available about stillbirths in the Italian population. We explored whether, at term of pregnancy, advanced maternal age is associated with an increased risk of stillbirth in Italy. We speculate that a policy of induction of labor at term of pregnancy in older mothers may significantly reduce the stillbirth. METHODS: Data provided by Italian Ministry of Health and National Statistical Institute were used to identify all singleton deliveries ≥22 weeks of gestation during a four years study period. We evaluated the outcome of pregnancy (livebirths or stillbirths) and we stratified data by gestational age and by maternal age at delivery. The hazard risk and the relative risk of stillbirth were calculated. RESULTS: The overall stillbirth rate was 3.4 per 1000, with a total of 6451 cases of stillbirths in the four years study period. Overall, the risk of stillbirth increases at term of pregnancy in all maternal age groups, especially in older mothers. A total of 674 stillbirths occurred in women aged 40 years or older and 24.2% of them (n = 163) occurred at term of pregnancy. Among women aged 40 years and above, 7.3% of stillbirths (49/674) occurred beyond 39 weeks of gestation. The hazard risk doubles from 39 to 40 weeks, from 0.60 per 1000 ongoing pregnancies to 1.16 per 1000 ongoing pregnancies; the relative risk at 40 weeks of gestation was the highest in the older mothers and was 5.17 (95% CI 3.16-8.46). CONCLUSIONS: The effect of maternal age on birth outcomes is a relevant aspect in Italy. If the association between maternal age and stillbirth is supposed to be part of the pathophysiology of fetal death, our data indicate that induction of labor before 40 weeks of gestation in women aged 40 years old or older might prevent overall 7.3% of stillbirths for induction at 39 weeks, 13% of stillbirths for induction at 38 weeks. To reduce potentially preventable stillbirths, caregivers should perform a specific risk assessment for each pregnant woman. The impact of maternal age should be seriously considered, and an individualized approach should be planned at term of pregnancy in older mothers, including the possibility of a slightly anticipation of induction of labor if spontaneously undelivered.
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Muerte Fetal , Mortinato , Adulto , Anciano , Femenino , Edad Gestacional , Humanos , Edad Materna , Embarazo , Factores de RiesgoRESUMEN
BACKGROUND: The purpose of this study was to describe the placental lesions in pregnancies complicated by hypertensive disorders (HDP) and/or fetal growth restriction (FGR) and in uneventful control pregnancies. METHODS: This is a case control study that included singleton pregnancies with HDP and normally grown fetus (HDP-AGA fetus), with HDP and FGR, early FGR, late FGR, and uneventful pregnancies. Feto-placental Doppler velocimetry and sFlt-1/PlGF ratio were performed. Placental histology was evaluated blinded according to the Amsterdam Consensus criteria. RESULTS: Placental lesions with maternal vascular malperfusion (MVM) were significantly more frequent in HDP-FGR and early FGR (92% and 83%). MVM were significantly associated with abnormal feto-placental Doppler parameters, especially in early FGR. Delayed villous maturation (DVM) was associated with late FGR (83%). HDP-AGA fetus cases presented a heterogeneous pattern of placental lesions, including 60% of cases with MVM, but were not associated with abnormal Doppler feto-placental velocimetry. CONCLUSIONS: We found a prevalence of placental maternal vascular malperfusion in HDP-FGR and early FGR groups. These lesions were also associated with abnormal, anti-, and angiogenic markers. Conversely HDP-AGA fetus and late FGR presented more heterogeneous placental lesions not severe enough to cause feto-placental Doppler anomalies. These conditions are likely associated with different etiologies, such as maternal pre-pregnancy risk factors for metabolic syndrome. These findings suggest a possible preventive nutritional approach in addition to low-dose aspirin in pregnant women with predisposing factors for HDP-AGA fetuses and late FGR.
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Hipertensión Inducida en el Embarazo , Enfermedades Placentarias , Estudios de Casos y Controles , Femenino , Retardo del Crecimiento Fetal/etiología , Humanos , Hipertensión Inducida en el Embarazo/epidemiología , Hipertensión Inducida en el Embarazo/prevención & control , Placenta/patología , EmbarazoRESUMEN
The aim of the present study is to detect the presence of SARS-CoV-2 of patients affected by COVID-19 in olfactory mucosa (OM), sampled with nasal brushing (NB) and biopsy, and to assess whether a non-invasive procedure, such as NB, might be used as a large-scale procedure for demonstrating SARS-CoV-2 presence in olfactory neuroepithelium. Nasal brushings obtained from all the COVID-19 patients resulted positive to SARS-CoV-2 immunocytochemistry while controls were negative. Double immunofluorescence showed that SARS-CoV-2 positive cells included supporting cells as well as olfactory neurons and basal cells. OM biopsies showed an uneven distribution of SARS-CoV-2 positivity along the olfactory neuroepithelium, while OM from controls were negative. SARS-CoV-2 was distinctively found in sustentacular cells, olfactory neurons, and basal cells, supporting what was observed in NB. Ultrastructural analysis of OM biopsies showed SARS-CoV-2 viral particles in the cytoplasm of sustentacular cells. This study shows the presence of SARS-CoV-2 at the level of the olfactory neuroepithelium in patients affected by COVID-19. For the first time, we used NB as a rapid non-invasive tool for assessing a potential neuroinvasion by SARS-CoV-2 infection.
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COVID-19 , SARS-CoV-2 , Biopsia , COVID-19/diagnóstico , Humanos , Mucosa Olfatoria/patologíaRESUMEN
BACKGROUND: Many postmortem studies address the cardiovascular effects of COVID-19 and provide valuable information, but are limited by their small sample size. OBJECTIVES: The aim of this systematic review is to better understand the various aspects of the cardiovascular complications of COVID-19 by pooling data from a large number of autopsy studies. DATA SOURCES: We searched the online databases Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and Web of Science for concepts of autopsy or histopathology combined with COVID-19, published between database inception and February 2021. We also searched for unpublished manuscripts using the medRxiv services operated by Cold Spring Harbor Laboratory. STUDY ELIGIBILITY CRITERIA: Articles were considered eligible for inclusion if they reported human postmortem cardiovascular findings among individuals with a confirmed SARS coronavirus type 2 (CoV-2) infection. PARTICIPANTS: Confirmed COVID-19 patients with post-mortem cardiovascular findings. INTERVENTIONS: None. METHODS: Studies were individually assessed for risk of selection, detection, and reporting biases. The median prevalence of different autopsy findings with associated interquartile ranges (IQRs). RESULTS: This review cohort contained 50 studies including 548 hearts. The median age of the deceased was 69 years. The most prevalent acute cardiovascular findings were myocardial necrosis (median: 100.0%; IQR, 20%-100%; number of studies = 9; number of patients = 64) and myocardial oedema (median: 55.5%; IQR, 19.5%-92.5%; number of studies = 4; number of patients = 46). The median reported prevalence of extensive, focal active, and multifocal myocarditis were all 0.0%. The most prevalent chronic changes were myocyte hypertrophy (median: 69.0%; IQR, 46.8%-92.1%) and fibrosis (median: 35.0%; IQR, 35.0%-90.5%). SARS-CoV-2 was detected in the myocardium with median prevalence of 60.8% (IQR 40.4-95.6%). CONCLUSIONS: Our systematic review confirmed the high prevalence of acute and chronic cardiac pathologies in COVID-19 and SARS-CoV-2 cardiac tropism, as well as the low prevalence of myocarditis in COVID-19.
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COVID-19 , Miocarditis , Anciano , Autopsia , Humanos , Pulmón , Miocarditis/epidemiología , SARS-CoV-2RESUMEN
Generalized Arterial Calcification of Infancy (GACI) is a rare disease inherited in a recessive manner, with severe and diffuse early onset of calcifications along the internal elastic lamina in large and medium size arteries. The diagnosis results are from clinical manifestations, imaging, histopathologic exams, and genetic tests. GACI is predominantly caused by biallelic pathogenic variant in the ENPP1 gene (GACI1, OMIM#208000) and, to a lesser extent, by pathogenic variants in the ABCC6 gene (GACI2, OMIM#614473). We present a novel variation in the ENPP1 gene identified in a patient clinically diagnosed with GACI and confirmed by genetic investigation and autopsy as GACI type 1. The sequence analysis of the patient's ENPP1 gene detected two heterozygous variants c.1412A>G (p.Tyr471Cys) and c.1715T>C (p.Leu572Ser). The variant c.1715T>C (p.Leu572Ser) has not been described yet in the literature and in mutation databases. A genetic analysis was also carried out for the parents of the newborn; the heterozygous pathogenic variant c.1412A>G (p.Tyr471Cys) was detected in the mother's ENPP1 gene, and a sequence analysis of the father's ENPP1 gene revealed the novel heterozygous variant c.1715T>C (p.Leu572Ser). Our results showed that the variant c.1715T>C (p.Leu572Ser) may have a pathogenic role in the development of GACI type1 (GACI1, OMIM#208000), at least when associated with the pathogenic c.1412A>G (p.Tyr471Cys) variant. The identification of novel mutations potentially enabled genotype/phenotype associations that will ultimately have an impact on clinical management and prognosis for the disease.
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OBJECTIVES: Obesity is an increasing health problem that has become a common medical disorder among women of childbearing age, representing worldwide a risk factor for stillbirth. The aim of the study is to evaluate the association between placental histopathologic findings and obesity in stillbirth. METHODS: Placentas were analyzed according to the Amsterdam consensus statement. Histologic findings in stillbirth from obese and lean mothers were analyzed and compared with those observed in liveborn controls. RESULTS: Stillbirth in obese mothers displayed placental pathology in all gestational ages, mostly at term of pregnancy. The most observed placental lesions were those consistent with maternal vascular malperfusion of the placental bed. Decidual arteriopathy and placental infarcts appeared specifically associated with maternal obesity. Moreover, obese women with stillbirth showed the highest cumulative number of placental lesions. CONCLUSIONS: Considering the significant association between stillbirth, maternal obesity, and placental histopathologic findings, health care providers should be aware about the importance of placental examination in obese women, especially in stillborn cases. The high prevalence of lesions consistent with vascular malperfusion of the placental bed suggests that stillbirth prevention strategies in obese women should rely on the development of tools to study and improve decidual artery functioning early in pregnancy.
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Obesidad Materna/patología , Enfermedades Placentarias/patología , Placenta/patología , Mortinato , Adulto , Femenino , Edad Gestacional , Humanos , Embarazo , Estudios Retrospectivos , Factores de RiesgoRESUMEN
AIMS: Vascular malformations (vMs) encompass a wide range of diseases often associated with somatic or, more rarely, germinal genetic mutations. A mutation in the PIK3Ca/mTOR pathway is more often involved in various vMs. CD10 and CD34 are cellular markers that may play a role in mesenchymal differentiation and proliferation. The aim of our study was to find a possible link between the immunohistochemical expression of CD10 and CD34 in vMs and their relationship with mutations in the PIK3CA/mTOR signaling pathway. METHODS AND RESULTS: Our study on 58 samples of vMs showed that in endothelial cells, CD10 was significantly expressed in PIK3CA-mutated samples compared with samples without any mutation (p < 0.05), especially and even more consistently when compared with samples with mutation in other pathways (p < 0.0001). Conversely, in the same PIK3CA-mutated samples, CD34 expression in endothelial cells was significantly reduced compared with samples either without any mutation or mutations in other pathways (p < 0.05 and p < 0.0005). Compared with samples with mutations in other pathways, a significant overexpression of endothelial CD10 was also found in samples with TEK/TIE2 mutation, a gene linked to the PIK3CA/mTOR pathway (p < 0.01). However, CD34 expression was not altered. In samples with PIK3CA mutation, the CD10 expression was significantly increased in the stroma compared with samples with TEK/TIE2 gene or other gene mutations (p < 0.05). CONCLUSION: Therefore, the CD10 and CD34 immunohistochemical profile could suggest/support the presence of mutations in the PIK3CA/mTOR pathway in samples of vMs.
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Antígenos CD34/análisis , Fosfatidilinositol 3-Quinasa Clase I/genética , Células Endoteliales/química , Mutación , Neprilisina/análisis , Receptor TIE-2/genética , Malformaciones Vasculares/genética , Malformaciones Vasculares/metabolismo , Adolescente , Adulto , Biomarcadores/análisis , Niño , Preescolar , Análisis Mutacional de ADN , Células Endoteliales/patología , Femenino , Predisposición Genética a la Enfermedad , Humanos , Inmunohistoquímica , Lactante , Masculino , Fenotipo , Malformaciones Vasculares/patología , Adulto JovenRESUMEN
AIMS: A considerable proportion of patients affected by coronavirus respiratory disease (COVID-19) develop cardiac injury. The viral impact in cardiomyocytes deserves, however, further investigations, especially in asymptomatic patients. METHODS: We investigated for SARS-CoV-2 presence and activity in heart tissues of six consecutive COVID-19 patients deceased from respiratory failure showing no signs of cardiac involvement and with no history of heart disease. Cardiac autopsy samples were collected within 2 h after death, and then analysed by digital PCR, Western blot, immunohistochemistry, immunofluorescence, RNAScope, and transmission electron microscopy assays. RESULTS: The presence of SARS-CoV-2 into cardiomyocytes was invariably detected in all assays. A variable pattern of cardiomyocyte injury was observed, spanning from absence of cell death and subcellular alterations hallmarks, to intracellular oedema and sarcomere ruptures. In addition, we found active viral transcription in cardiomyocytes, by detecting both sense and antisense SARS-CoV-2 spike RNA. CONCLUSIONS: In this autopsy analysis of patients with no clinical signs of cardiac involvement, the presence of SARS-CoV-2 in cardiomyocytes has been detected, determining variable patterns of intracellular damage. These findings suggest the need for cardiologic surveillance in surviving COVID-19 patients not displaying a cardiac phenotype.
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The widely accepted dogma of intrauterine sterility and initial colonization of the newborn during birth has been blurred by recent observations of microbial presence in meconium, placenta, and amniotic fluid. Given the importance of a maternal-derived in utero infant seeding, it is crucial to exclude potential environmental or procedural contaminations and to assess fetal colonization before parturition. To this end, we analyzed sterilely collected intestinal tissues, placenta, and amniotic fluid from rodent fetuses and tissues from autoptic human fetuses. Total bacterial DNA was extracted from collected samples and analyzed by Next Generation Sequencing (NGS) techniques using hypervariable 16S ribosomal RNA (rRNA) regions (V3-V4). Colonizing microbes were visualized in situ, using labeled probes targeting 16S ribosomal DNA by fluorescent in situ hybridization. The NGS analysis showed the presence of pioneer microbes in both rat and human intestines as well as in rodent placentas and amniotic fluids. Microbial communities showed fetus- and dam-dependent clustering, confirming the high interindividual variability of commensal microbiota even in the antenatal period. Fluorescent in situ hybridization analysis confirmed the microbes' presence in the lumen of the developing gut. These findings suggest a possible antenatal colonization of the developing mammalian gut.
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Líquido Amniótico/microbiología , Desarrollo Embrionario/fisiología , Intestinos/microbiología , Microbiota , Placenta/microbiología , Animales , Femenino , Humanos , Intestinos/embriología , Embarazo , ARN Ribosómico 16S/metabolismo , RatasRESUMEN
Neural tube defects (NTDs) are the second most common congenital malformations in humans affecting the development of the central nervous system. Although NTD pathogenesis has not yet been fully elucidated, many risk factors, both genetic and environmental, have been extensively reported. Classically divided in two main sub-groups (open and closed defects) NTDs present extremely variable prognosis mainly depending on the site of the lesion. Herein, we review the literature on the histological and pathological features, epidemiology, prenatal diagnosis, and prognosis, based on the type of defect, with the aim of providing important information based on NTDs classification for clinicians and scientists.
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Defectos del Tubo Neural/epidemiología , Defectos del Tubo Neural/genética , Defectos del Tubo Neural/metabolismo , Anencefalia/complicaciones , Femenino , Humanos , Embarazo , Diagnóstico Prenatal , Factores de RiesgoRESUMEN
Cornelia de Lange syndrome (CdLS) is an inherited condition with a wide spectrum of phenotypic anomalies, consisting mainly of growth impairment, multi-organ abnormalities, and neurocognitive delay. Clinical diagnostic criteria after birth are well defined, whereas when to suspect the syndrome during intrauterine life still remains undefined. This review summarizes the main possible prenatal findings in CdLS, suggesting that a skilled ultrasound scan in cases of intrauterine growth restriction associated with other fetal abnormalities may improve the chance of prenatal diagnosis of CdLS, especially in families known to be at high risk. We propose that, following a sequence of detailed scans and examinations, CdLS affected fetuses could be diagnosed in utero, when one or more conditions (among them, intrauterine growth restriction, limb defects, facial abnormalities, diaphragmatic hernia, and heart diseases) are detected, and possibly confirmed by specific molecular testing. Birth Defects Research 109:771-777, 2017. © 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc.
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Síndrome de Cornelia de Lange/diagnóstico por imagen , Síndrome de Cornelia de Lange/diagnóstico , Ultrasonografía/métodos , Femenino , Retardo del Crecimiento Fetal , Humanos , Deformidades Congénitas de las Extremidades , Masculino , Embarazo , Diagnóstico Prenatal/métodosRESUMEN
OBJECTIVE: Autophagy is an inducible intracellular process acting under stressor conditions, such as infections, inflammation and hypoxia. The aim of the present study was to analyze autophagy expression in preterm delivered human placenta. METHODS: Autophagy marker LC3 was analyzed in 25 consecutive human placentas delivered before 34 weeks of gestation, analyzed by immunohistochemistry, immunofluorescence and quantitative real-time PCR, according to the histologic classification of preterm delivery (PTD) (cases with or without placental inflammatory lesions). RESULTS: LC3 expression was observed both in cases with and without inflammatory lesions. In cases with histological inflammation, strong immunoreactivity for LC3 autophagic marker was observed in the inflammatory cell infiltration composed by neutrophils. In all PTD cases, trophoblastic cells in chorion laeve express LC3, with variable staining intensity: a significant reduction of LC3 expression was observed in chorion laeve of PTD with histological inflammation compared to PTD without inflammatory lesions. Moreover, the decrement of LC3 staining was observed to be associated to the increasing severity of the histological signs of fetal inflammatory response. CONCLUSIONS: Our data show that the expression of LC3 varies depending on different histological features, indicating an interesting and possibly clinically relevant relation between autophagy expression levels and the inflammatory status.
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Proteínas Relacionadas con la Autofagia/genética , Autofagia , Corioamnionitis/metabolismo , Proteínas Asociadas a Microtúbulos/metabolismo , Placenta/metabolismo , Nacimiento Prematuro/genética , Trofoblastos/patología , Estudios de Casos y Controles , Corion/metabolismo , Femenino , Expresión Génica , Humanos , Placenta/patología , Embarazo , Reacción en Cadena en Tiempo Real de la Polimerasa , Método Simple Ciego , Trofoblastos/metabolismoRESUMEN
Autophagy is a catabolic process involved in the preservation of energy homeostasis and its dysregulation has been implicated in the development of metabolic disorders, including diabetes mellitus. Gestational diabetes mellitus represents a risk for fetal morbidity and mortality. The present study focuses on the autophagy process in human diabetic placenta and fetal pancreas, compared with controls. Analysis of the autophagy markers LC3, Beclin-1 and p62 suggests an impairment of the autophagy process in diabetic placentas. Results indicate an association between gestational diabetes and autophagy, emphasizing the importance of unravelling the mechanisms regulating this relationship.
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Autofagia , Diabetes Gestacional/fisiopatología , Feto/fisiopatología , Páncreas/fisiopatología , Placenta/fisiopatología , Adulto , Biomarcadores/metabolismo , Estudios de Casos y Controles , Femenino , Humanos , Proteínas Asociadas a Microtúbulos/metabolismo , Páncreas/metabolismo , Placenta/metabolismo , EmbarazoRESUMEN
BACKGROUND: Fetal acidemia at birth is defined as a newborn condition wherein the cord blood pH value is less than 7.0. It could represent an association with newborn brain damage; therefore, it is important to investigate which conditions precipitate its occurrence. No extensive placental analysis has been performed in cases of acidotic newborns delivered from low-risk pregnancies. AIMS: To study placental characteristics in cases with severe fetal acidemia. STUDY DESIGN: Retrospective case-control study. SUBJECT: 34 cases, 102 controls. OUTCOME MEASURES: Umbilical artery pH was measured at delivery from a doubly clamped portion of the cord. Placental characteristics were compared between cases with severe fetal acidemia (cord pH at birth <7.0) and controls (normal pH at birth) in term low-risk pregnancies. RESULTS: Macroscopic placental and umbilical cord characteristics were comparable in cases and controls whereas histological characteristics exhibited differences: diffuse villous edema, increased number of syncytial knots and villous branching abnormalities significantly affected cases more frequently than controls. Diffuse villous edema is related to fetal vascularization and associated with an increase of venous pressure; in our low-risk population, it is conceivable that these changes of fetal flow and pressure occurred in labor during the alteration of fetal heart rate. An increased number of syncytial knots and villous branching abnormalities have been previously associated with chronic placental hypoxic condition; in our low-risk population they could reflect a clinically undetectable hypoxic situation that acted during pregnancy reducing fetal resources to bear labor and delivery. CONCLUSIONS: Placental histology provides useful information related to fetal acidemia in low-risk term pregnancy.
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Acidosis/sangre , Ácidos/sangre , Sangre Fetal/metabolismo , Enfermedades Fetales/sangre , Placenta/patología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Recién Nacido , Masculino , EmbarazoRESUMEN
Autophagy is an inducible catabolic process by which cells degrade and recycle materials to survive stress, starvation, and hypoxia. The aim of this study was to evaluate autophagy at the fetal-maternal interface, to assess autophagy involvement during the early phase of human gestation, and to explore autophagic modification in case of early abnormal pregnancy outcome. Specimens were collected from first-trimester normal gestations undergoing legal termination of pregnancy and first-trimester sporadic spontaneous miscarriages. Autophagy was studied in villous and decidual samples by transmission electron microscopy, immunohistochemistry, immunofluorescence, and Western blotting. Autophagy markers were found in cytotrophoblast, syncytiotrophoblast, extravillous trophoblast, and decidual stromal cells. Autophagy is physiologically involved in early normal gestation. Compared with normal pregnancy, spontaneous miscarriage presents an increase in autophagy expression in villous specimens due to an increment in concentration of autophagic vacuole in syncytiotrophoblast, suggesting a cytoprotective mechanism of the cells to respond to microenvironmental challenge.
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Aborto Espontáneo/metabolismo , Autofagia/fisiología , Vellosidades Coriónicas/metabolismo , Decidua/metabolismo , Primer Trimestre del Embarazo/metabolismo , Aborto Espontáneo/patología , Adulto , Vellosidades Coriónicas/patología , Decidua/patología , Femenino , Humanos , Intercambio Materno-Fetal/fisiología , Embarazo , Adulto JovenRESUMEN
Induction of labor is one of the most used procedures in obstetrics, performed to achieve vaginal delivery through cervical ripening and stimulation of uterine contractions. We investigated the impact of induction of labor upon placental autophagy, a catabolic pathway activated in response to alteration of the physiological intracellular conditions. We collected 28 singleton placentas at the time of uncomplicated term vaginal delivery (7 spontaneous onset of labor, 21 induced labor). Autophagy was evaluated by immunohistochemistry, immunofluorescence, and immunoblotting. No significant difference in the autophagy expression was found between spontaneous or induced onset of labor. We found an inverse relationship between autophagy expression and the maternal prepregnancy body mass index, irrespective of the mode of labor onset. This result could be related to the nutritional maternal habits before and throughout pregnancy rather than rapid metabolic changes during labor.
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Autofagia/genética , Trabajo de Parto Inducido , Proteínas Asociadas a Microtúbulos/biosíntesis , Parto/metabolismo , Índice de Masa Corporal , Hormona Liberadora de Corticotropina/metabolismo , Femenino , Regulación de la Expresión Génica , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Proteínas Asociadas a Microtúbulos/genética , Parto/genética , Placenta/metabolismo , EmbarazoRESUMEN
We investigated the role of carbohydrate antigen sialyl-Lewis a (sLea), an E-selectin ligand and epitope of tumor marker CA19.9, in the development of xenografts in nude mice. To this end, animals were inoculated with the human colon cancer cell line HCT-15, expressing no Lewis antigens, or with a clone expressing sLea (HCT-15-T5). The size of HCT-15-T5 xenografts appeared larger than those of HCT-15 and their average weight was over twice bigger. In both xenografts the mitotic index was found elevated, as determined by Ki-67 assay, and no apoptosis was detected in the tumor cells by both caspase 8 or TUNEL assays. Some apoptotic signals were instead detected in the vessels. Conversely, microvessel density, determined through CD-31 immunohistochemistry, was found 3.2-folds bigger in HCT-15-T5 xenografts (p<0.012). Only the membranes of HCT-15-T5 cells grown as xenografts reacted intensively with the anti CA19.9 antibody 1116-NS-19-9 by immunofluorescence, but not by immunohistochemistry. Unknown structures were instead stained by such technique in both xenografts, as were in mouse tissues not expressing the antigen and in human colon adenocarcinoma. We conclude that expression of sLea on the surface of colon cancer cells improves xenograft growth and is associated with enhanced angiogenesis, while immunohistochemistry with 1116-NS-19-9 antibody appears not suitable to determine CA19.9 expression.