| Objective: Preeclampsia,characterized by hypertension in pregnant women,remains a leading cause of maternal and fetal morbidity and mortality worldwide.The basic pathological change is small systemic vascular spasm.Although PE etiology remains unclear,it is suggested that the progression of preeclampsia was closely related to the shallow placental implantation,oxidative stress,and activation of the coagulation system,inflammation and metabolic disorders.The dysfunction of placental trophoblastic cells and villus structure stability has been considered crucial to PE pathophysiology.To play control functions,a variety of protein factors such as GCM family,Syncytin,placental growth factor,soluble vascular endothelial growth factor and HtrA family are needed for placental trophoblast cells.GCM1(GCMa),which is an essential transcription factor in the differentiation and fusion of trophoblast,regulates the expression of many genes and involves in the proliferation,differentiation and integration of placental trophoblast cells.Syncytin-1,which is mainly expressed in the syncytiotrophoblast,has been identified as the envelope protein of a human endogenous retrovirus family HERVW.GCM1,a transcription factor,regulates the expression of Syncytin-1.The two factors play an important role in the proliferation,differentiation,and fusion,apoptosis of trophoblast cells and maintenance of the control pregnancy.The aim of this study was to assess the expression and clinical significance of GCM1 and Syncytin-1 in peripheral blood and placenta in preeclampsia patients and normotensive pregnancy women,in order to clarify a prediction of preeclampsia and provide reliable objective basis for early diagnosis.Methods:1 Subjects: According to The Guidelines for diagnosis and treatment of hypertensive disorders complicating pregnancy(2015),We randomly selectedpatients from the Second Hospital of Hebei Medical University from 2015-06 to 2016-08.We selected 130 cases of severe preeclampsia patients and 61 cases of normal pregnant women,total of 191 cases.There was divided into three groups,According to gestational age(GA)at the onset of the disease,PE had been classified as early(GA ? 34 weeks)and late(GA >34 weeks)(63cases with E-PE and 67 cases with L-PE),and 61 normotensive pregnant without complications as control group were enrolled in this study.2 Sample collecting: venous blood samples were collected from the elbow vein before any treatment.The blood samples were centrifuged by2000 rpm,10 minutes at room temperature.The serum was collected and stored at-80? for the concentration analysis of GCM1 and Syncytin-1.After delivery of placenta,placental tissue was collected in the center of maternal placenta and avoid calcification.It was stored in 10% formalin at room temperature for 48 h and conventionally dehydrated and paraffin embedded.3 The experiment indicators: Enzyme-linked immunohistosorbent assay(ELISA)was used to detect the concertration of GCM1 and Syncytin-1 in maternal serum.Distribution of GCM1 and Syncytin-1 expression in the placenta was observed by Immunohistochemical technique(IHC).We recorded age,gestational week at delivery,height,weight,blood pressure and other indicators.4 Statistical methods: The results were analyzed by the SPSS 21.0software.Results:1 The expression of GCM1 in the serum level of control group was(11.61±2.27)ng/ml.It was(4.44±0.70)ng/ml in E-PE,and(7.27±0.97)ng/ml in L-PE.Serum levels of GCM1 were decreased in women with preeclampsia compared to women with control pregnancy(P<0.05).And the value in the E-PE was lower than that in the L-PE(P<0.05).The expression of GCM1 in the serum level of 30-31+6 weeks group,32-34 weeks group,34+1-36+6 weeks group,?37 weeks respectively(3.99±0.47)ng/ml,(4.87±0.50)ng/ml,(6.76±0.86)ng/ml,(7.99 ±0.71)ng/ml.By statistical analysis,30-31+6 week groupcompared with the 32-34 week group,the expression level of GCM1 decreased,32-34 group compared with 34+1-36+6 group,the expression level of GCM1 decreased,34+1-36+6 weeks group with ? 37 weeks compared expression levels also decreased,the differences were statistically significant(P<0.05).The expression of Syncytin-1 in the serum level of control group was(10.47±0.62)ng/ml,it was(3.98±0.81)ng/ml in E-PE,and(7.73±1.14)ng/ml in L-PE.Serum levels of Syncytin-1 were decreased in women with preeclampsia compared to women with control pregnancy(P<0.05).And it was lower in the E-PE than that in L-PE(P<0.05).The expression of Syncytin-1 in the serum level of 30-31+6 weeks group,32-34 weeks group,34+1-36+6 weeks group,?37 weeks was respectively(3.65±0.40)ng/ml,(4.43±0.82)ng/ml,(6.81±0.87)ng/ml,(8.15±1.36)ng/ml.By statistical analysis,30-31+6 week group compared with the 32-34 week group,the expression level of GCM1 decreased,32-34 group compared with 34+1-36+6group,the expression level of GCM1 decreased,34+1-36+6 weeks group with?37 weeks compared expression level also decreased,the differences were statistically significant(P<0.05).2 It showed that GCM1 and Syncytin-1 were expressed in placenta of preeclampsia and control pregnant women using the IHC.GCM1 is mainly expressed in the cytoplasm of syncytiotrophoblast,and a small amount of expression is in the nucleus of cytotrophoblast.Syncytin-1 is mainly expressed in the membrane and cytoplasm of syncytiotrophoblast.The average expression level of GCM1 in the cytoplasm of syncytiotrophoblast was(0.34±0.06)in control group,and it was(0.16±0.02)in E-PE,and it was(0.23±0.03)in L-PE.The levels of GCM1 were decreased in women with preeclampsia compared to women with control pregnancy(P<0.05).and it was lower in the E-PE than that in L-PE(P<0.05).The expression of GCM1 in the placenta level of 30-31+6 weeks group,32-34 weeks group,34+1-36+6weeks group,?37 weeks group was respectively(0.14±0.01),(0.17±0.01),(0.22±0.02),(0.24±0.03),By statistical analysis,30-31+6 week group compared with the 32-34 week group,the expression level of GCM1 decreased,32-34 group compared with 34+1-36+6 group,the expression level of GCM1 decreased,34+1-36+6 weeks group with ? 37 weeks group compared expression levels also decreased,the differences were statistically significant(P<0.05).The expression level of Syncytin-1 in control group was(0.31±0.02),and it was(0.15±0.02)in E-PE,and(0.25±0.03)in L-PE.The levels of Syncytin-1 were decreased in women with preeclampsia compared to women with control pregnancy(P<0.05).and it was lower in the E-PE than that in the L-PE(P<0.05).The expression of Syncytin-1 in the serum level of 30-31+6weeks group,32-34 weeks group,34+1-36+6 weeks group,?37 weeks group was respectively(0.14±0.02),(0.16±0.02),(0.22±0.03),(0.24±0.02),By statistical analysis,30-31+6 week group compared with the 32-34 week group,the expression level of Syncytin-1 decreased,32-34 group compared with34+1-36+6 group,the expression level of Syncytin-1 decreased,34+1-36+6weeks group with ? 37 weeks compared expression levels also decreased,the differences were statistically significant(P<0.05).3 HE staining results: Placental villi matured well in normotensive pregnancy.The blood vessels were rich and morphology was control in placentas villi and stroma,and the nucleuses of syncytiotrophoblast were arranged orderly on the surface of villi in normotensive pregnancy women.There were immature placental villi,disordered arrangement of the nucleus of syncytiotrophoblasts,decreased incompletion of elastic membrane,and hyaline degeneration of arteriolar smooth muscle cells in L-PE.The number of placental villi became fewer in E-PE,and there were obviously degeneration and necrosis in the villi and syncytiotrophoblast cell fusion largely on the surface of villi.4 There is a positive correlation between GCM1 and Syncytin-1 in maternal serum and placenta tissue(r=0.84;r= 0.84,P<0.01;respectively).Conclusion:1 The levels of GCM1 and Syncytin-1 in serum were decreased in women with preeclampsia.Moreover,the value in E-PE group is lower than that in L-PE.The earlier the disease happened,the lower the experssion ofGCM1 and Syncytin-1 were.2 The levels of GCM1 and Syncytin-1 in placental tissue were decreased in women with preeclampsia.Moreover,the value in E-PE group is lower than that in L-PE.The earlier the disease happened,the lower the experssion of GCM1 and Syncytin-1 were.3 There is a positive correlation between the level of GCM1 and Syncytin-1 both in maternal serum and placenta tissue,which indicates that GCM1 and Syncytin-1 play an important role in preeclampsia. |
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