SEVERE PRE-ECLAMPSIA COMPLICATED BY HELLP SYNDROME IN THE HOFFBAUER AND SYNCYTIOTROPHOBLAST CELLS (ULTRASTRUCTURAL AND IMMUNOHISTOCHEMICAL STUDY)

Year 2022, Volume: 8 Issue: 2, 91 - 98, 31.12.2022

Yusuf Nergiz , Şebnem Nergiz Öztürk , Fırat Aşır , Engin Deveci , Muhammet Erdal Sak , Mehmet Sıddık Evsen , Selcuk Tunik , Uğur Şeker

https://doi.org/10.51477/mejs.1166842

Cited By: 1

Abstract

The aim of this study was to evaluate the immunohistochemistry and ultrastructural of syncytiotrophoblast and Hoffbauer cells in placental villi of HELLP syndrome patients. Placental samples with twenty control (normotensive) and twenty HELLP syndrome were fixed in 10% neutral formalin solution for paraffin-embedding wax protocol. Placental samples were fixed in 2.5% buffered glutaraldehyde and then, in 1% osmium tetra oxide for routine electron microscopic procedure. When the HELLP group fetal placental sections were examined, intracytoplasmic edema in syncytiotrophoblast, degenerative vacuoles and degenerative findings on cell surface membranes were observed. Moreover, villous edema was remarkable. The number of CD68 positive Hoffbauer cells per villus control group sections was 0.23 ± 0.02 and the number of CD68 positive cells per villus in HELLP group placenta sections was 0.83 ± 0.12 . The increase in the number of Hoffbauer cells per villus in the HELLP group was statistically significant (p <0.00). Compared with the control group, there was a significant increase in the number of Hoffbauer cells and syncytiotrophoblast in HELLP group, and also degenerative changes were observed in ultrastructural structure of these cells.

Keywords

HELLP, Hoffbauer cell, syncytiotrophoblast, immunohistochemistry, placenta

Project Number

13-TF-89

References

• 1. Suresh, M.S. “HELLP Syndrome: An anesthesiologist’s perspective. Anesthesiology”, Clinics of North America,16 (2):331-48,1998.
• 2. Weinstein, L., “Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy”, American Journal of Obstetrics and Gynecology,142:159-67, 1982.
• 3. Sibai, B. M., Taslimi, M. M., el-Nazer, A., Amon, E., Mabie, B. C., Ryan, G. M., “Maternal-perinatal outcome associated with the syndrome of hemolysis, elevated liver enzymes, and low platelets in severe preeclampsia-eclampsia”, American Journal of Obstetrics and Gynecology,155 (3):501-9,1986.
• 4. Jones, C.J., Choudhury, RH., Aplin, J.D., “Functional changes in Hoffbauer cell glycobiology during human pregnancy”, Placenta, 36:1130-7,2015.
• 5. Clark, D.E., Smith, S.K, Sharkey, A.M., Charnock-Jones, D.S., “Localization of VEGF and expression of its receptors flt and KDR in human placenta throughout pregnancy”, Human Reproduction , 11:1090-1098, 1996.
• 6. Seval, Y., Korgun E.K. Demir R., “Hoffbauer cells in early human placenta: Possible implications in vasculogenesis and angiogenesis”, Placenta, 28: 841-845, 2007.
• 7. Grigoriadis, C., Tympa, A., Creatsa, M., Bakas, P., Liapis, A., Kondi-Pafiti, A., Creatsas, G., “Hoffbauer cells morphology and density in placentas from normal and pathological gestations”, Revista Brasileira de Ginecologia e Obstetrícia, 35: 407-412, 2013.
• 8. Karakaya, Y.A., Ozer, E., “The role of Hoffbauer cells on the pathogenesis of early pregnancy loss”, Placenta, 34:1211-5, 2013. 9. Fisher, S.J., Laine, R.A., “High alpha-amylase activity in the synctiotrophoblastic cells of first trimester human placentas”, Journal of Cellular Biochemistry, 22: 47-54,1983.
• 10. Jones, C.J., Fox, H., “Syncytial knots and intervillous bridges in the human placenta: an ultrastructural study”, Journal of Anatomy, 124(2):275-286, 1977.
• 11. Kerr, J.F., Wyllie, A.H., Currie, A.R., “Apoptosis: a basic biological phenomenon with wide-ranging implications in tissue kinetics”, British Journal of Cancer, 26(4):239-257,1972.
• 12. Smith, S.C., Baker, P.N. Symonds EM., “Increased placental apoptosis in intrauterine growth restriction”, Am J Obstet Gynecol ,177 (6): 1395-401,1997.
• 13. Leung, D.N., Smith, S.C., To, K.F., Sahota, D.S., Baker, P.N., “Increased placental apoptosis in pregnancies complicated by preeclampsia”, American Journal of Obstetrics and Gynecology,184 (6):1249-50, 2001.
• 14. Allaire, A.D., Ballenger, K.A., Wells, S.R., Mahon, M.J., Lessey, B.A., “Placental apoptosis in preeclampsia”, Obstetrics & Gynecology, 96 (2):271-6, 2000.
• 15. Rath, G., Bastia, B., Sood, M., Mukherjee, A., “The effects of passive smoking on the terminal villi of human placenta”, Journal of the Anatomical Society of India, 50:24-27,2001.
• 16. Brunoria, L., Battinic, L., Brunoric, E., Lenzic, P., Paparelli, A., “Placental barrier breakage in preeclampsia: ultrastructural evidence”, European journal of obstetrics, gynecology, and reproductive biology, 2:182–189, 2010.
• 17. Roberts, J.M., Taylor, R.N., Goldfien, A., “Clinical and biochemical evidence of endothelial cell dysfunction in the pregnancy syndrome preeclampsia”, American Journal of Hypertension, 4:700-8, 1991.
• 18. Goldstein, J., Braverman, M., Salafia, C., Buckley, P., “The phenotype of human placental macrophages and its variation with gestational age”, The American Journal of Pathology, 133:648-659, 1988 .
• 19. Evsen, M. S., Kalkanli, S., Deveci, E., Sak, M. E., Ozler, A., Baran, O., Erdem, E., Seker, U., “Human placental macrophages (Hoffbauer cells)in severe preeclampsia complicated by HELLP syndrome:immunohistochemistry of chorionic villi”, Analytical and quantitative cytology and histology, 35(5): 283-288, 2013.
• 20. Wetzka, B., Clark, D. E., Charnock-Jones, D. S., Zahradnik, H. P., Smith, S. K., “Isolation of macrophages (Hoffbauer cells) from human term placenta and their prostaglandin E2 and thromboxan production”, Human Reproduction,12 (4):847-852.