| Accreta complicating complete placenta previa is characterized by reduced systemic levels of vascular endothelial growth factor and by epithelial-to-mesenchymal transition of the invasive trophoblast. | |
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MedLine Citation:
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PMID: 21316642 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We sought to characterize serum angiogenic factor profile of women with complete placenta previa and determine if invasive trophoblast differentiation characteristic of accreta, increta, or percreta shares features of epithelial-to-mesenchymal transition. STUDY DESIGN: We analyzed gestational age-matched serum samples from 90 pregnant women with either complete placenta previa (n = 45) or uncomplicated pregnancies (n = 45). Vascular endothelial growth factor (VEGF), placental growth factor, and soluble form of fms-like-tyrosine-kinase-1 were immunoassayed. VEGF and phosphotyrosine immunoreactivity was surveyed in histological specimens relative to expression of vimentin and cytokeratin-7. RESULTS: Women with previa and invasive placentation (accreta, n = 5; increta, n = 6; percreta, n = 2) had lower systemic VEGF (invasive previa: median 0.8 [0.02-3.4] vs control 6.5 [2.7-10.5] pg/mL, P = .02). VEGF and phosphotyrosine immunostaining predominated in the invasive extravillous trophoblasts that coexpressed vimentin and cytokeratin-7, an epithelial-to-mesenchymal transition feature and tumorlike cell phenotype. CONCLUSION: Lower systemic free VEGF and a switch of the interstitial extravillous trophoblasts to a metastable cell phenotype characterize placenta previa with excessive myometrial invasion. |
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Authors:
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Mark J Wehrum; Irina A Buhimschi; Carolyn Salafia; Stephen Thung; Mert O Bahtiyar; Erica F Werner; Katherine H Campbell; Christine Laky; Anna K Sfakianaki; Guomao Zhao; Edmund F Funai; Catalin S Buhimschi |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2011-02-12 |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 204 ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-07-26 Completed Date: 2011-10-07 Revised Date: 2012-10-09 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 411.e1-411.e11 Citation Subset: AIM; IM |
Copyright Information:
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Published by Mosby, Inc. |
Affiliation:
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Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA. mark.j.wehrum@us.army.mil |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Case-Control Studies Epithelial-Mesenchymal Transition Female Humans Keratin-7 / metabolism Phosphotyrosine / metabolism Placenta Accreta / metabolism*, pathology Placenta Previa / metabolism*, pathology Pregnancy Pregnancy Proteins / blood Trophoblasts / metabolism*, pathology Vascular Endothelial Growth Factor A / metabolism* Vascular Endothelial Growth Factor Receptor-1 / blood Vimentin / metabolism |
| Grant Support | |
ID/Acronym/Agency:
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K12 HD 1027766/HD/NICHD NIH HHS; R01 HD 047321/HD/NICHD NIH HHS; R01 HD047321-05/HD/NICHD NIH HHS; R03 HD 50249/HD/NICHD NIH HHS; R03 HD050249-02/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Keratin-7; 0/Pregnancy Proteins; 0/Vascular Endothelial Growth Factor A; 0/Vimentin; 144589-93-5/placenta growth factor; 21820-51-9/Phosphotyrosine; EC 2.7.10.1/Vascular Endothelial Growth Factor Receptor-1 |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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