Expression Of HGF And VEGF In Chorionic Villi And Decidua Of Recurrent Spontaneous Abortion Patients

Objective:Recurrent spontaneous abortion defined as 3 or more than 3 times consecutive spontaneous abortion. RSA is a common complication of pregnancy. According to the literatures, it has been estimated to be about 1% of all pregnancies[1], about 15%-20% of early spontaneous abortion. RSA almost occurred in the early stage of pregnancy, and often in the same stage of gestation, which made the patients and their families suffered a lot. In addition,mutiple abortions may lead to secondary infertility. There are still over 50% RSA for unknown reasons in the etiology according to the reports[1]. Hepatocyte growth factor is a pleiotropic cytokine from the mesenchymal cells.It's an important regulatory factor in mitosis and morphogenesis on various target cells. HGF is expressed by villous mesenchyme in the placenta,and it has important roles on placental morphogenesis, stimulating trophoblast migration and promoting angiogenesis. Studies have shown that lack of HGF result in early embryonic lethality. HGF synthesises increased in injured tissue and promotes healing. Vascular endothelial growth factor is an important regulator of placental angiogenesis, some studies have shown that in the RSA, VEGF levels decreased [2], but others have also drawn the opposite conclusion.At present, there are no reports about the expression of HGF in RSA patients.Our reaserch measured the HGF and VEGF level in villus and decidua of RSA patient and controls, in order to discuss the relationship of unexplained recurrent abortion and the factors above.Methods:20 unexplained repeated spontaneous abortion patient at the Obstetrics and Gynecology department clinic of the Second Hospital of Hebei Medical University were selected randomly,date from July 2010 to February 2011.All patients satisfied the criteria below: 3 or more than 3 times first trimester abortion, without acute or chronic diseases, without chromosomal anomalies, genital malformations, endocrine disorders, immune factors and infections.20 healthy women who required for artificial abortion of the same period were selected as control group. The two groups had no statistically different in age, days of pregnancy and size of gestational sac.The villus and decidua tissue were cleaned in 0.9% NaCl solution, separated into about 1.0×1.0×1.0cm , and immediately put in 4% paraformaldehyde solution for 24 to 48 hours. Studied by immunohistochemically staining for the expression of HGF, the results were analyzed by the method of semi-quantitative way.Results:1 Comparision of HGF level in the villi: HGF was mainly contained in the villi, the trophoblast cells in the cytoplasm and nucleus of syncytiotrophoblast cells, normal villi stained uniform, lighter colored, while RSA group stained darker (Fig. 3). HGF level of the RSA group was higher than NEP group, the difference was statistically significant (t = 28.697, p <0.01, Table 2).2 Comparision of HGF level in the decidua: HGF in the decidua expressed mainly in the cytoplasm of glandular epithelial cells, some decidual cells were colored in NEP group, and a lot stained unclear could been in RSA group(See Figure 4). HGF level of the RSA group was higher than NEP group, the difference was statistically significant (t = 20.228, p <0.01, Table 3).3 Comparision of VEGF level in the villi: VEGF was mainly expressed in villous cytotrophoblast and syncytiotrophoblast cytoplasm, rather than the nucleus(see Figure 5). VEGF level of the RSA group was higher than NEP group, the difference was statistically significant (t=11.34,p<0.01,Table 4).4 Comparision of HGF level in the decidua: VEGF was mainly expressed in the cytoplasm of decidual cells, glandular epithelial cells and vascular endothelial cell (see Figure 6). VEGF level of the RSA group was higher than NEP group, the difference was statistically significant (t=2.389,p<0.05,Table 5).5 Correlation between HGF and VEGF: There is no correlation between the level of HGF and VEGF in villous and decidua in two groups. (r1=0.016,p>0.05.r2=0.145,p>0.05. r3=0.334,p>0.05.r4=0.134,p>0.05)。Conelusion:1Villus and decidual of RSA group have higher expression of HGF than that of the control group, and the difference was statistically significant. Suggest the the increased HGF is association with RSA .2 Villus and decidual of RSA group have higher expression of VEGF than that of the control group, and the difference was statistically significant. Suggest the the increased VEGF is association with RSA .3 There is no correlation between the level of HGF and VEGF in villous and decidua in two groups.