Expression And Clinical Significance Of Caspase3 And HSP70 In Placenta Of The Patient With Intrahepatic Cholestasis Of Pregnancy

Objective: To observe the expression of caspase3 and HSP70 in placenta of normal woman and the patient with ICP(Intrahepatic Cholestasis of Pregnancy), so as to find the role of the caspase3 and HSP70 in the pathogenesis of ICP and give us a clue in forecasting the prognosis of neonatal outcome with ICP.Methods: Collecting the placenta tissues from 70 patients who received cesarean section before labor from Dec 2013 to Aug 2014 in Affiliated Hospital of North Sichuan Medical College. 35 of them had no other complications except ICP, 35 of them were normal pregnant women with single fetus and no medical complications. Then to observe the expression of Caspase3 and HSP70 in the placenta of the two groups by HE staining and immunohistochemistry(SP method), in the meanwhile to analysis the relevant medical records.Results: 1)The gestational weeks of the patient in ICP group was 36.51+1.94 weeks, the gestational weeks of the patient in control group was 38.93+ 1.63 weeks, it was statistically significant(P<0.05). 2)In HE staining, there were no obvious pathological differences in the syncytiotrophoblase cells, cytotrophoblast cells, deciduas cells, villous stromal cells, and villi vascular cells between two groups. 3) caspase3 and HSP70 expressed in the placenta of the control group, the mild ICP group and the severe ICP group, the difference of the expression intensity in the three groups was statistically significant(2χ =18.434 P<0.05, 2χ =26.33 P<0.05);the expression in the mild ICP group and the severe ICP group was significantly higher than that in the control group(P<0.05), the expression in the severe ICP group was significantly higher than that in the mild group(P<0.05). 4)The expression of the caspase3 in the ICP group had a positive correlation with the expression of the HSP70 in the ICP group(r=0.348,P<0.05). 5) To compare the weight of neonates in control group and ICP group. The weight of neonates in control group was higher than that in the control group(P<0.05), and there was no difference in the neonate Apgar score between two groups(P>0.05).Conclusion: 1. Caspase3 expressed both in the placenta of ICP group and control group. The gestational weeks of neonate in ICP group was less than that in control group, but the expression was increased in the ICP group, and the expression had a positive correlation with the severity of the disease, which suggest caspase3 expressed earlier in ICP group than that in control group. 2. HSP70 expressed in the placenta of the ICP group and control group. The expression was increased in the ICP group and has a positive correlation with the severity of the disease, which suggest HSP70 expressed earlier and stronger in ICP group than that in control group. 3. The expression of caspase3 and HSP70 in ICP has a positive correlation. As we know caspase3 and HSP70 are two important regulatory proteins in apoptosis, which suggest both caspase3 and HSP70 may play a role in the happening and development of ICP. 4. Caspase3 and HSP70 expressed earlier and stronger in the placenta of the ICP group. In addition, we should continue to detect the caspase3 and HSP70 in maternal serum, they may become good markers for assessing the severity of ICP, for predicting neonatal outcome, as well as deciding the time to terminate the pregnancy.