Expression And Meaning Of Placenta Tissue PDGF-A And VCAM-1 In Hypertensive Disorders Complicating Pregnancy

Hypertensive disorders complicating pregnancy (HDCP) is a special disease in period in pregnancy, including gestational hypertension, pre- eclampsia, eclampsia, pre-eclampsia superimposed upon chronic hypertension , and chronic hypertension in pregnancy. In former, gestational hypertension, pre-eclampsia, and eclampsia were called pregnancy- induced hypertension syndrome (PIH). The incidence of our country is 9.4%, and 7-12% in abroad. Because of the hyperkinesias of small artery, the high systemic vascular resistance, the endothelial injury and capillary leak, the clinical finding is a triad of edema,hypertension,and proteinuria occurring primarily after the 20th gestational week, companying dysfunction of other organs. Now, the cause of hypertensive disorders complicating pregnancy is unknown. The relatively new theory of endothelial injury explains many of the clinical findings in preeclampsia-eclampsia. According to recent study, it is widely considered that, the development of HDCP maybe have something to do with some kind of factor. This factor leads to embryo-matrix immunity imbalance, which may cause growth impeded of uterus-placenta vessel, placenta ischemia, endothelial injury, multisystem and multi-organ injury. At last, HDCP has to take place. Many researches state clearly that, the characteristic change of pathophysiology is atherosclerosis(AS) of placental helicine arteries. PDGF-A and VCAM-1 play an important role in the establishment of endothelial disorder and atherosclerosis, and take part in occurrence and development of hpertensive disorders complicating pregnancy. Objective: To discuss the expression of the platelet-derived growth factor PDGF-A and endothelial cell adhesion molecule VCAM-1 on the placenta tissue in the case of hypertensive disorders complicating pregnancy (HDCP) and their effect on the start and development of HDCP.Methods: Apply immunohistochemistry an expression for turning the method of Envision examining 38 HDCPs patients and later period in 22 normal gestations placentases organizing inside PDGF-A with VCAM-1.The brown granules of PDGF-A and VCAM-1 positive cell were mainly distrbuted in cytomembrane and cytoplasm. In each slide, a section of strong PDGF-A and VCAM-1 staining were routinely included as a positive control.Five non-overlapping fields of view were examined per biopsy in a systematic random sampling pattern(magnifcation×400). Result of the reactions and analysis of the clinical course of the patients were subjected to statistical analysis.RESULT: 1.The expression of PDGF-A in HDCP patients and normal placenta issuePDGF-A expresses in placental cytotrophoblasts including the cytotropholast and syncytial-tropholast and in endovascular cells, among them positive expression of placental cytotrophoblasts is 24 cases in 38 HDCP patients, and the rate is 63.16%. The positive expression of placental cytotrophoblasts is 7 cases in 22 normal pregnancy later period, and the rate is 32.82%. The PDGF-A expression of HDCP patients in placental cytotrophoblasts is higher than that of normal pregnancy obviously. There was significant difference( P<0.05). The positive expression of endovascular cells is 26 cases in 38 HDCP patients, and the rate is 68.42%. The positive expression of endovascular cells is 6 cases in the normal pregnancy later period, and the rate is 27.27%. The PDGF-A expression of HDCP patients in endovascular cells is higher than that of normal pregnancy obviously. There was significant difference(P<0.005).2. The expression of PDGF-A in placenta issue of different grade HDCP patientsThe positive expression of placental cytotrophoblasts is 7 cases in 18 prophase eclampsia patients, and the rate is 38.89%. The positive expression of placental cytotrophoblasts is 17 cases in 20 serious pre-eclampsia/eclampsia patients, and the rate is 85.00%. There was significant difference in the expression of PDGF-A in placenta cytotrophoblasts of both grades HDCP patients( P < 0.005). The expression of PDGF-A raised obviousely along with the ingravescence of hypertensive disorders complicating pregnancy. The positive expression of endovascular cells is 10 cases in 18 pre-eclampsia patients, and the rate is 55.56%. The positive expression of endovascular cells is 16 cases in serious pre-eclampsia/eclampsia patients, and the rate is 80.00%. There was no difference(P>0.05).3. The expression of VCAM-1 in HDCP patients and normal placenta issueVCAM-1 expresses in placental cytotrophoblasts including the cytotropholast and syncytial-tropholast and in endovascular cells.It is mainly expressed in placental endovascular cells of HDCP patients,and it can be expressed partly in both cytotropholast and endovascular cells. And it is mainly expressed in placental cytotropholast of the normal placenta issue,and it can be also expressed partly in both cytotropholast and endovascular cells.The positive expression of placental cytotrophoblasts is 8 cases in 38 HDCP patients, and the rate is 21.05%. The positive expression rate of placental cytotrophoblasts is 14 cases in 22 normal pregnancy later period, and the rate is 63.64%. The VCAM-1 expression of HDCP patients in placental cytotrophoblasts is lower than that of normal pregnancy obviously. There was significant difference( P < 0.005). The positive expression of endovascular cells is 17 cases in 38 HDCP patients, and the rate is 44.74%. The positive expression rate of endovascular cells is 7 cases in the normal pregnancy later period, and the rate is 31.82%. There was no significant difference(P> 0.05). The VCAM-1 expression of HDCP patients in placental cytotrophoblasts is lower than that of normal pregnancy obviously.4. The expression of VCAM-1 in placenta issue of different grade HDCP patientsThe positive expression of placental cytotrophoblasts is 3 cases in 18 pre-eclampsia patients, and the rate is 16.67%. And the positive expression of placental cytotrophoblasts is 5 cases in 20 serious pre-eclampsia /eclampsia patients, and the rate is 25.00%. There was no significant difference (P>0.05). The positive expression of endovascular cells is 6 cases in 18 pre-eclampsia patients, and the rate is 33.33%. The positive expression of endovascular cells is 11 cases in serious pre-eclampsia/ eclampsia patients, and the rate is 55.00%. There was no difference(P>0.05). The VCAM-1 positive expressions of different grade HDCP patients in placental cytotrophoblasts and endovascular cells are both no difference.CONCLUSION: 1.PDGF-A was mainly expressed in placental cytotrophoblasts and endovascular cells. PDGF-A take part in the pathophysiology process of HDCP. 2. As HDCP patient,s condition grew worse, PDGF-A was higher expressed. PDGF-A can be a sign to determine the state of HDCP. 3. VCAM-1 was lowly expressed in placental cytotrophoblasts.It was indicated that HDCP patients were to be short of endothelial phenotype. It was possible that there was some relationship between the start and development of HDCP and lacking of the VCAM-1 expression in placental cytotrophoblasts of HDCP patients. 4. PDGF-A and VCAM-1 participate in occurrence and development of HDCP, which can provide a new thought to the occurrent, development, diagnosis and treat of HDCP.