| Objective：Severe pre-eclampsia (PE),which with hypertension after20weeks of gestation, proteinuria and at least one distinctive clinical sign orsymptom, is one type of hypertensive disorder complicating pregnancy(HDCP). It has done great harm to pregnant women, fetus and newborn.It isone of the main reasons that lead to increased the mortality rates of maternaland perinatal. Its etiology and pathogenesis are unclear. In recent years, manyscholars agree that the degressive invasion ability of trophocyte is one ofmain reasons to PE. In early pregnancy, extravillous trophoblasts (EVT) intouterine decidua to shallow1/3myometrium, damage vascular middle muscleelastic fibers, then complete the physiological spiral artery recasting, form alow resistance, high flow rate of placental circulation system, to ensure thefetus’s growing demand for blood flow. Under normal circumstances thisprocess has strict temporal and spatial dependence, in other words, thesechanges occur only on the early stages of pregnancy in time and shallow1/3myometrium in spatial terms.However, spiral artery in PE with physiologicalchanges only in deciduas of uterine artery,30%-50%of the placentadecidual plate spiral arteries and even no sertoli cell invasion, result in heuterine artery diameter smaller, placental hypoperfusion and lead to PE.Insulin-like growth factor-Ⅱ(IGF-Ⅱ) is a kind of polypeptide, similar to theproinsulin’s structural, is an important growth factor in human. It can promotecell division, differentiation and maturation, and inhibit apoptosis. Thesynthesis of IGF-Ⅱ in placenta come from itself. It is mainly composed ofplacental villi lobular fit nourish cells, nourish cells and cells in the amnioticmembrane fluff layer. IGF-Ⅱ,with the ability to promote cell mitosis andmetabolism，may affect the formation and function of placenta in many ways.The present study suggests that IGF-Ⅱcan participate in the Invasion of the placenta. Insulin-like growth factor-Ⅱ mRNA binding protein3(IMP3) is oneof the members of the insulin-like growth factor Ⅱ mRNA binding proteinfamily, is a kind of secretory proteins that can combined with insulin-likegrowth factors (IGFs), can unify highly specific encoding the insulin-likegrowth factor Ⅱ mRNA, participate in the location of the insulin-like growthfactor Ⅱ mRNA, by adjusting the insulin-like growth factor Ⅱ mRNAstability of transportation, translation, and to participate in the regulation ofcell polarity, movement, and proliferation activity, is closely related to theinvasion and metastasis of cells. According to the relationship of IMP3withinvasion and metastasis of cells, presumably, its abnormal expression maychanges of sertoli cell infiltration, plays an important role in the happeningand the development of PE. This study using immunohistochemical methodrespectively testing IGF-Ⅱand IMP3expression in placenta tissues of patientswith pregnancy severe PE and normal pregnant women, to explore thedifferent expression, in order to find cause of severe PE for clinical provides anew basis, and improve the early diagnosis of pregnancy hypertension diseaseand early treatment. Moreover, it maybe can provide new trains of thought onthe pathogenesis and treatment of severe preeclampsia.Methods：Specimens selected from October2012to October2013in the maternityof The Second Hospital of He Bei Medical University.The normal pregnantwomen and the patients with severe preeclampsia were120cases. Select28-34weeks of pregnancy in patients with severe preeclampsia30cases as earlyonset group(S1),28-34weeks of pregnancy in patients of premature labour30cases as the control group of early onset(N1),34-42weeks of pregnancy inpatients with severe preeclampsia30cases as late onset group(S2), a normalpregnancy30cases as control group of late onset(N2). The pregnant womenwere selected as the first child, the ages of pregnant women were22-29, therewas no statistically difference, without the history of essential hypertension,diabetes, heart disease and kidney disease, thyroid dysfunction, etc. Thediagnosis of severe preeclampsia according to the people’s medical publishing house, Jie Le editor of journal of《obstetrics and gynecology》(7th edition)standard. In addition to the premature rupture of membrane, pregnancycomplications and local complications, the control group of early onset wascomposed of premature labours. Samples were drawn from maternal placentaplacenta villi surface near the umbilical cord root tissue, about1.0㎝×1.0㎝×1.0㎝,and keep away from the hemorrhage, necrosis and calcification area.Fixed with4%formaldehyde solution, embeded paraffin, and preparedparaffin sections. And then tested IGF-Ⅱand IMP3expression in placentatissues with immunohistochemical method.All of the experimental data usedSPSS13.0statistical software for data processing, differences during groupswith rank sum test, correlation analysis using the rank correlation, associatedwith intensity correlation coefficient r said. P<0.05as a statistically significantdifference.Results：1Gestational age28to34weeks of severe pre-eclampsia IGF-ⅡandIMP3expressions in placenta tissue were both obviously lower than prematurelabours, and the differences were both statistically significant(P<0.001).2Gestational age less than34weeks of severe pre-eclampsia IGF-ⅡandIMP3expressions in placenta tissue were both lower than normal pregnantwomen, but there was no statistically significant difference (PIMP3=0.70>0.05,PIGF-Ⅱ=0.63>0.05).3Gestational age28to34weeks of severe pre-eclampsia IGF-ⅡandIMP3expressions in placenta tissue were both obviously lower thangestational age34to42weeks of severe pre-eclampsia, and the differenceswere both statistically significant(P<0.001)..4IGF-Ⅱ and IMP3protein expression in placenta tissue had a positivecorrelation(r=0.818).Conclusion：IGF-Ⅱand IMP3in the placental tissues of patients withearly onset severe PE significantly were both lower than normal expressionpregnant women, maybe lead to bad sertoli cell infiltration, shallow placentaimplantation, result in severe PE. IGF-Ⅱand IMP3expression of placental tissues between late onset severe PE patients and normal pregnancy had nosignificant difference. Possibly, there may be other pathogenesis in late-onsetsevere PE. IGF-Ⅱand IMP3in the placental tissues of patients with earlyonset severe PE significantly were both lower than late-onset severe PE.Probably, there may exist different pathogenesis between the2groups. IGF-Ⅱ and IMP3protein expression in placenta tissue appeared positivecorrelation, prompting that maybe there are no negative feedback mechanism. |
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