The Expression Of Insulin Like Growth Factor-â…¡ And Insulin Like Growth Factor Binding Protein-1 On Preeclampsia Of Hypertensive Disorder Complicating Pregnancy

Objective: Preeclampsia is a severe complication of pregnancy. It is one of significant factors to increase maternal, perinatal and neonatal morbidity and mortality. Hypertensive disorder complicating pregnancy is associated with abnormally shallow cytotrophoblast invasion. It's vascular remodeling in the spiral arteties is confined to the decidual portion. Many factors effect nurse cells infiltrating. There are many investigations of the expression of IGF-Ⅱin normal placenta and its role in nurse cell infiltrating. Chakraborty[1] found IGF-Ⅱpromote nurse cell infiltration, differentiation and placentation. But there is less investigations of its expression in preeclampsia placenta in internal and abroad. Its mechanism of action of nurse cell infiltration in HDCP is poorly understood. Recent investigation discover IGFBP-1 is associated with nurse cell generation or encroachment. Its abnormal expression maybe play an important role in the developing of HDCP. The topic elucidate the possible relationship between IGF-Ⅱ/ IGFBP-1 expression and the pathogenesis of preeclampsia. To investigate the expression of IGF-Ⅱand IGFBP-1 in placental of women with preeclampsia and normal pregnancy.Methods: Placental samples were obtained in 30 minutes after delivery from 18 normal pregnancy women and 19 patients with mild preeclamptic pregnancies, 21 with severe preeclampsia. The villi were taken from them. All placentas were obtained from women undergoing spontaneous labor when they took on caesarean surgery. All tissues were routinely fixed in 10 percent formalin and embedded in paraffin. Four-μm-thick tissue sections of all samples were stained by immuno- histochemical analysis. Statistical analyses were performed with the use of the SPSS 12.0. Kruskal-Wallis H test and spearman rank correlation were used to analyze the data,α<0.05 was considered statistically significant.Result: 1 The three groups were matched in maternal age, parity and gestational age. 2 In the study, IGF-Ⅱwas localized to placental villus lobule syneytiotrophoblast and langhans cell. The concentrations of immunoreactive IGF-Ⅱon placental villus lobule syneytiotrophoblast and langhans cell were highest, positive rate was 83.33% and that of severe preeclampsia were almost negative, positive rate was 28.57% mild preeclampsia had weaker expression, positive rate was 47.37%(showed by Fig.1, 3,5, table 1). The difference between the normal placenta and mild preeclampsia placenta was statistically significant (P<0.05); the difference between the normal placenta and severe preeclampsia placenta was statistically significant (P<0.01); the experiments found significant difference in IGF-Ⅱbetween severe and mild preeclampsia placenta (P<0.05). 3 IGFBP-1 was localized to placental decidual cells and part villus nurse cells. The expression of IGFBP-1 on severe preeclampsia was the strongest, positive rate was 95.24%, and that of normal placenta was almost negative, positive rate was 27.78% mild preeclampsia had weaker expression, positive rate was 78.95%(Showed by Fig.2,4,6, table 2). The difference between the normal placenta and mild preeclampsia placenta was statistically significant (P<0.05); the difference between the normal placenta and severe preeclampsia placenta was statistically significant (P<0.01); the experiments found significant difference in IGFBP-1 between severe and mild preeclampsia placenta (P<0.05). 4 No correlation was found between IGF-Ⅱand IGFBP-1 expressions in normal groups (r=0.097,P>0.05), in patients with severe preeclampsia and mild preeclampsia, IGF-Ⅱexpression showed negative correlation with IGFBP-1 expression (r=-0.2663,P<0.05;r=-0.3691, P<0.05).Conclusion: Based on the data mentioned above, we can come to the following conclusions: Being the important cell growth factors , IGF-Ⅱand IGFBP-1 play an significant role in the development of HDCP . The expression of IGF-Ⅱin placenta of normal pregnancy group is stronger than the HDCP group, and the expression of IGFBP-1 is weaker. Negative correlation was found between IGF-Ⅱand IGFBP-1 expression in severe and mild preeclampsia groups. IGF-Ⅱand IGFBP-1 may play an important role in placental trophoblast invasion. Abnormal expression of IGF-Ⅱand (or) IGFBP-1 may affect acquisition of an invasive by trophoblasts, resulting in the abnormal shallow trophoblast invasion of the uterus that is associated with preeclampsia.