The Study Of Vascular Proliferation And Apoptosis In Villi And Decidual Tissues In Patients With Unexplained First Trimester Spontaneous Abortion

Objective: To investigate the expression of vascular proliferation related factors placental growth factor(PLGF) and solubility kinase insert domain receptor-1(sFlt-1) and apoptosis related factor cysteine protease-3(Caspase-3) in the villi and decidua tissue of patients with unexplained early spontaneous abortion. To analysis the apoptosis index of trophoblasts cells and decidual cells at the same time.Method: 30 patients with unexplained early spontaneous abortion (named as unexplained abortion group), 30 patients with early drug abortion(named as drug abortion group) and normal early pregnancy women who required artificial abortion (named as artificial abortion group) are selected as research objects and collected the villi and decidual tissues respectively. Apoptosis of trophoblasts cells and decidual cells are detected by terminal deoxynucleotidy transferase-mediated dUTP-biotin nick end labeling (TUNEL) method. The expressions of Caspase-3, PLGF and sFlt-1 in three groups of villi and decidual tissues are detected by SP immunohistochemistry method.Results1. The expressing position of Caspase-3,PLGF and sFlt-1 in villi and decidual tissue: Caspase-3, which is brown particle, was expressed in nucleus and cytoplasm of trophoblastic cells simultaneously. PLGF and sFlt-1, which is also brown particle, was expressed mainly in cytoplasm of trophoblastic cells. In decidual tissue, Caspase-3 was expressed in nucleus and cytoplasm of decidual cells, PLGF and sFlt-1 was expressed in cytoplasm of decidual cells.2. The expression of Caspase-3 and sFlt-1 in trophoblastic and decidual tissues in three groups: there is significantly statistical difference in expression of Caspase-3 and sFlt-1 in trophoblastic and decidua tissues in three groups (P <0.01). The expression of Caspase-3 in villi (0.426±0.044) and decidual(0.418±0.052) tissue of unexplained abortion group is significantly higher than that in drug abortion group(0.281±0.051 and 0.287±0.041) and artificial abortion group(0.304±0.041 and 0.311±0.034), P <0.05 for all. The expression of sFlt-1 in villi(0.432±0.042) and decidua (0.436±0.044)tissue in unexplained abortion group is also significantly higher than that in drug abortion group (0.299±0.041 and 0.292±0.039)and artificial abortion group(0.281±0.044 and 0.277±0.035), P <0.05 for all. In villi and decidual tissue, there were no difference of Caspase-3 and sFlt-1 expression betweet drug abortion group and artificial abortion group(P>0.05).3. The expression of PLGF in trophoblastic and decidual tissues in three groups: in three groups, there is significantly statistical difference in expression of PLGF in trophoblastic and decidual tissues (P <0.01). In unexplained abortion group, the expression of PLGF in villi(0.321±0.035) and decidua(0.318±0.022) tissue is obviously lower than that in drug abortion group (0.414±0.046 and 0.447±0.044) and artificial abortion group (0.405±0.029 and 0.412±0.034), P<0.05 for all. In villi and decidua tissues, the PLGF expression showed no significantly difference between drug abortion group and artificial abortion group (P>0.05).4. The apoptosis degree of trophoblastic and decidua cells in three groups: after TUNEL staining, apoptosis of villi and decidua tissue showed brown-yellow particle in nucleolus. There is significantly difference of apoptosis index in three groups, including trophoblastic and decidual tissues (P <0.01 for all). The apoptosis index of villi (50.2±5.2)% and decidua (48.6±4.4)% tissue in unexplained abortion group is much higher than that in drug abortion group[ (19.1±4.2)% and (18.4±3.9)%] and artificial abortion group [(18.0±4.0)% and (18.4±3.7)%], P <0.05 for all. The apoptosis index of villi and decidua tissue in drug abortion group showed no significantly difference with the artificial abortion group (P>0.05).Conclusions:1. The occurrence of unexplained early spontaneous abortion may be related to over apoptosis of placenta villi. The increased expression of Caspase-3 may play an important role during the occurrence of apoptosis.2. The occurrence of unexplained early spontaneous abortion may be related to the blood vessel dyspoiesis of villi and decidua,which is caused by the PLGF expression deficiency and sFlt-1 over expression.