Authors : John Paul Judson, Lee Pui Fun, Vishna Devi Nadarajah, Sivalingam Nalliah, Srikumar Chakravarthi, P. Thanikhacalam and L. Santhanaraj
Abstract: Gestational hypertension and preeclampsia account for 5-7% of the maternal mortality and morbidity worldwide. Gestational hypertension and preeclampsia is characterised by blood pressure of 140/90 mm Hg or greater after the 20th week of gestation. The aetiology of gestational hypertension and preeclampsia is closely related to the disorder of placenta implantation. It is thought that shallow trophoblast invasion into maternal decidua causes malfunction of the utero-placental arteries, thus leading to both the diseases. The exact cause of shallow trophoblast invasion remains controversial. Placenta implantation involves activation and migration of trophoblast into the decidua and myometrium. These processes are dependent on keratin expression where activation of appropriate adhesion molecules and integrins are essential for appropriate trophoblast activity. This integrated study aimed to detect and analyse the trophoblastic keratin expression, as well as to examine the placenta ultrastructure for presence of degenerative changes in normal, gestational hypertensive and preeclamptic placenta. Immunofluorescence double staining method was performed on placental sections and trophoblastic expression of keratin 19 (K19) and keratin 18 (K18) were analysed qualitatively and quantitatively in normal (n = 10), gestational hypertensive (n = 10) and preeclamptic (n = 10) placenta. Statistical analysis of means was performed using one-way ANOVA. Representative placental samples from each of three groups were analysed via electron microscopy. Immunofluorescence results showed that both K19 and 18 expression in gestational hypertension and preeclampsia were reduced compared to normal but significant reduction was observed only for K19 expression in gestational hypertensive placenta. Gestational hypertensive placenta showed more reduction than preeclampsia for both keratins. Electron microscopic results demonstrated obvious degeneration and significant changes in the placental ultrastructure in all representative samples of gestational hypertension and preeclampsia when compared to normal. The redearchers conclude that the fundamental link exists between keratin expression and placental ultrastructural changes. The present keratin findings, especially in gestational hypertension, need to be confirmed by larger studies in future.
John Paul Judson, Lee Pui Fun, Vishna Devi Nadarajah, Sivalingam Nalliah, Srikumar Chakravarthi, P. Thanikhacalam and L. Santhanaraj, 2010. Ultrastructural and Immunofluorescence Studies of Placental Tissue in Hypertensive Diseases of Pregnancy. Research Journal of Biological Sciences, 5: 155-163.