| Objective: Recent studies on preeclampsia have suggested that its pathogenesis is related to the abnormal immune balance at the maternal-fetal interface,namely the decidua basalis.This study attempts to explore the pathogenesis of preeclampsia by studying the expression level of CXCL-16 in placental tissue and the change of the thickness and structure of decidua basalis,discussing the correlation between the expression level of CXCL-16 in placenta and the thickness and structure of decidua basalis in patients with preeclampsia.Methods: Pregnant women who were hospitalized in the obstetrics department of the First Affiliated Hospital of China Medical University from October 2020 to September 2022 were selected as the survey subjects.A total of 24 pregnant women with preeclampsia were selected,including 14 cases of severe preeclampsia,which were in the severe PE group.There were 10 patients with mild preeclampsia,who were in the mild PE group;A total of30 normal pregnant women who were hospitalized during the same period and delivered by cesarean section were selected as the normal control group.The general clinical data of the study subjects,placental tissue at the time of delivery,and the thickness of the decidua basalis in each group were measured microscopically after HE staining.The level of CXCL-16 in each placental tissue was detected by immunohistochemistry.Statistical methods such as t-test,one-way ANOVA and Spearman correlation analysis were used to analyze the differences in the thickness of the decidua basalis and CXCL-16 expression level in placental tissue and their clinical significance.Results: 1.The thickness of the decidua basalis in the three groups was severe PE group(0.1657±0.0321mm),mild PE group(0.1310±0.0317mm),and control group(0.1152±0.0186mm).The thickness of the decidua basalis in the severe PE group was thicker than that in the mild PE group and the control group,and the difference was statistically significant(all P<0.05),and the difference in the thickness of the decidua basalis between the mild PE group and the control group was not statistically significant(P>0.05),but the mean value of the mild PE group was higher than that in the control group.2.The results of immunohistochemical experiments suggest that CXCL-16 is expressed in the cytoplasm and cell membrane of trophoblasts.CXCL-16 in placental tissue of normal control group showed obvious positive staining.The expression level of placenta CXCL-16 in the control group was statistically significant than that in the mild PE group and the severe PE group(all P<0.05),and there was no significant difference in CXCL-16 expression between the mild PE group and the severe PE group(P>0.05).3.The thickness of the decidua basalis is negatively correlated with the expression level of placental CXCL-16(correlation coefficient:-0.364,P<0.05).Conclusion: The decidua basalis thickened in patients with preeclampsia,and the decidua basalis thickened significantly in patients with severe preeclampsia,the expression of placental CXCL-16 was lower than that in the control group,and the expression of severe PE group was significantly reduced,and the thickness of the decidua basalis was inversely correlated with the expression level of placental CXCL-16.It was suggested that the decrease in the expression level of CXCL-16 in placental tissue in patients with preeclampsia may lead to a decrease in the phagocytic ability of trophoblasts,a decrease in the ability to invade and migrate,insufficient degradation of the decidua collagen fibers,abnormal structure of the decidua basalis and thickening of the thickness,affecting the exchange of maternal-fetal interface substances,causing insufficient placental perfusion,and finally causing the onset of preeclampsia.This study focuses on the significance of the structural changes of the decidua caused by the immune imbalance of the maternal-fetal interface for the pathogenesis of preeclampsia,and pays attention to the phagocytosis function of trophoblasts,which proposes a new direction for the study of the pathogenesis of preeclampsia. |
