Decidual vascularization and the expression of angiogenic growth factors and proteases in first trimester spontaneous abortions

BACKGROUND Decidual vascular development is important for implantation. This study analysed decidual vascular adaptation to implantation in correlation with miscarriage in decidual secretory endometrium (DSE), decidua parietalis (DP) and decidua basalis (DB) of miscarriage patients and matched contr...

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Published in:	Human reproduction (Oxford) Vol. 24; no. 1; pp. 185 - 197
Main Authors:	Plaisier, M., Dennert, I., Rost, E., Koolwijk, P., van Hinsbergh, V.W.M., Helmerhorst, F.M.
Format:	Journal Article
Language:	English
Published:	Oxford Oxford University Press 01-01-2009 Oxford Publishing Limited (England)
Subjects:	Abortion, Spontaneous - etiology Abortion, Spontaneous - metabolism Abortion, Spontaneous - pathology Adult angiogenic factors Angiogenic Proteins - metabolism Antigens, CD - metabolism Antigens, Differentiation, Myelomonocytic - metabolism Apoptosis Biological and medical sciences Biomarkers - metabolism Case-Control Studies Caspase 3 - metabolism CD56 Antigen - metabolism Cell Proliferation decidua Decidua - blood supply Decidua - metabolism Decidua - pathology Embryo Implantation - physiology Female Gynecology. Andrology. Obstetrics Humans Immunohistochemistry Ki-67 Antigen - metabolism Medical sciences missed abortion Peptide Hydrolases - metabolism Pregnancy Pregnancy Trimester, First RNA, Messenger - metabolism uterine natural killer cells vascularization angiogenic factors vascularization uterine natural killer cells missed abortion decidua Pregnancy disorders Angiogenic factor Enzyme First trimester Decidua Abortion Vascularization Natural killer cell Pregnancy Peptidases Vertebrata Mammalia Uterus Female genital system Hydrolases Growth factor
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Summary:	BACKGROUND Decidual vascular development is important for implantation. This study analysed decidual vascular adaptation to implantation in correlation with miscarriage in decidual secretory endometrium (DSE), decidua parietalis (DP) and decidua basalis (DB) of miscarriage patients and matched controls. METHODS Decidua was obtained during first trimester termination of pregnancy (controls) and vacuum aspiration in case of missed abortion (cases). Vascularization and the expression of VEGF-A, placental growth factor, Flt-1, KDR, angiopoietin (Ang)-1, Ang-2, TIE-2, and membrane-type matrix metalloproteinases MT1-, MT2-, MT3- and MT5-MMP were determined at mRNA and protein level. Uterine natural killer cells (CD56), macrophages (CD68), proliferation (Ki67) and apoptosis (activated caspase-3) were evaluated in consecutive sections. RESULTS Decidual vascularization showed differences between cases and controls, i.e. fewer vessels with larger circumference in cases. This correlated with the differential expressions of various factors at mRNA/antigen level and with increased endothelial flt1, KDR, MT2- and MT5-MMP expression in miscarriage patients. The differences between cases and controls were probably not based on altered proliferation and/or apoptosis, since Ki67 and active Caspase-3 showed comparable expression levels in both groups. Although DB of cases and controls showed similar amounts of CD56- and CD68-positive cells, the case group did show elevated levels of CD56 in DSE (P < 0.05) and of CD68 in DP compared with the control group (P < 0.05). CONCLUSIONS The differences in vascularization and in the expression of angiogenic factors and proteases between groups suggest a correlation between decidual vascularization and the occurrence of miscarriages.
Bibliography:	ark:/67375/HXZ-LQGXKLKM-G ArticleID:den296 istex:51A41AC24B1225B5AE75CFB51887C9A9C07F0AFA ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0268-1161 1460-2350
DOI:	10.1093/humrep/den296