The Expression And Siganificance Of CB, PAI-1 And Avβ3 Integrin In Placenta Of Severe Eclampsism

Background and ObjectiveHypertensive disorder complicating pregnancy (HDCP) is a specific disease in pregnancy. Its incidence rate is 9.4% inland. Severe pre-eclampsia is one categories of HDCP and develops very fast. It is important for serious complication and increasing mortality in peripartum. But so far, the pathogenesis of HDCP has not been illuminated clearly. Placenta shallow invasion means trophoblastic cell invasiveness descending, this is a hot spot at present. Many factors can influence trophoblastic cell invasiveness.Extracellular matrix degradation and endometrial receptivity influence trophoblastic cell invasiveness. But sofar the pathogenesis of it was not recognized clearly.Cathepsin B is a proteinase, its main function is proteolysis. It has got more and more attention in HDCP pathogenesis. Plasminogen activator inhibitor-1(PAI-1) affects the capability of trophoblast cell invasion through reducing cell stick of vitronectin. av(33 Integrin is a heterodimeric transport receptor, and controls cell exterior and interior signal transduction. It is the marker of endometrial receptivity,and participates in trophoblast adhesion and immigration.It has not been reported the correlations among CB, PAI-1 and avβ3 Integrin in severe pre-eclampsia placenta in domestic and abroad literature. This study evaluated the expression levels and correlations of CB, PAI-1 and Integrin avβ3 in severe pre-eclampsia and normal pregnancy placenta, and analyzed the expressions of CB, PAI-1 and Integrin av(33, to approach the etiopathogenisis and nosogenesis in the course of pre-eclampsia. So, we may provide new ways and rationale for early diagnosis and therapy of severe eclampsism.MethodsStreptavidin perorxidase immunostaining technique and image analysis technique were used to examine the expression of CB,PAI-land av(33 Integrin in the severe pre-eclampsia group. There were 45 cases in severe pre-eclampsia and 30 cases in normal group to analyze the expression levels and correlations of CB, PAI-1 and avβ3 Integrin.Rusults1. CB was mainly located in the cytoplasm of placental syncytiotrophoblast and placental villus cells in placenta, less in the nucleus of decidual cell and villus syncytiotrophoblast;The expression level of CB in the placental villus syncytiotrophoblast of severe pre- eclampsia(144.63±2.76)was significantly higher than those in normal group(107.87±4.16) (p<0.05).2. PAI-1 was mainly located in the cytoplasm of placental syncytiotrophoblast. The expression level of PAI-1 in the placental syneytiotrophoblast of severe pre-eclampsia (146.55±7.32) was significantly higher than that in normal group(102.21±5.29)(p<0.05).3.avβ33Integrin was mainly located in the nucleus of placental villus syncytiotrophoblast and villus interstitial cell, The expression level of av(33 Integrin in the placental villus syncytiotrophoblast of severe pre- eclampsia(100.70±3.35) was much lower than that in normal group(147.60±6.24) (p<0.05).4. The correlation among CB, PAI-1 and avβ3Integrin expression levels in severe pre-eclampsia placenta:There was a significant negative correlation between CB and PAI-1 expression level (r1=-0.912, p<0.05), a positive correlation between CB and avβ3 Integrin expression level (r 2=0.648, p<0.05), and a negative correlation between PAI-1 and avp3 Integrin expression level (r3=-0.627, p<0.05).Conclusions 1.The expression level of CB in severe pre-eclampsia placenta was high. It may take part in the pathogenesis of severe pre-eclampsia.2. The expression level of PAI-1 in severe pre-eclampsia placenta was high. It may take part in the pathogenesis of severe pre-eclampsia.3.The expression level of avP3 Integrin in severe pre-eclampsia placenta was low. It may participate in the pathogenesis of severe pre-eclampsia.4. In the course of pre-eclampsia CB and PAI-1 have antagonistic action;CB and avβ3Integrin have synergistic action;PAI-1 and avβ3Integrin have antagonistic action;They affects each other and participate in the development of severe pre-eclampsia.5.CB,PAI-1 and avP3 Integrin may become a molecular maker in in severe pre-eclampsia, but the role in in the pathogenesis of severe pre-eclampsia has a long way to investigate.