Background/aim: Impaired lymphatic function is associated with pathological conditions. The presence of placental lymphatics is still under debate. This study evaluates the placental podoplanin expression in normotensive and preeclamptic women with and without HIV. Materials and methods: Normotensive (n = 60) and preeclamptic (n = 120) pregnant women were stratified into early and late onset preeclampsia and further divided by HIV status. Immunostaining was performed using the podoplanin antibody prior to the morphometric image analysis. Results: Podoplanin was immunolocalized in a reticular-like stroma complex within the exchange and conducting villi. The immunoexpression of podoplanin was significantly upregulated in the exchange villi (P = 0.001) irrespective of the pregnancy type and HIV status. Based on pregnancy type, podoplanin was downregulated in early onset preeclampsia (15.33 ± 4.27%) compared to late onset preeclampsia in the exchange villi (17.85 ± 4.74%; P = 0.04). Podoplanin was upregulated in HIV+ vs. HIV-cases regardless of pregnancy and villi type. Irrespective of pregnancy type, podoplanin immunoexpression within exchange villi was different (P = 0.008) between the HIV+ and HIV-groups. Conclusion: Placental fluid homeostasis is maintained by a podoplanin reticular-like complex within conducting and exchange villi, being upregulated in HIV-positive pregnancies.

Background: The first trimester of pregnancy remains an unknown immunological adaptation. Cytokines and syncytiotrophoblast microvesicles (STBM) have been identified as key factors involved in the maternal immune adaptation. This study therefore aims to determine the levels of T helper cell 1 (Th1) and 2 (Th2) associated cytokines TNF-α and IL-6 in relation to the relative concentration of STBM's in maternal circulation. Materials and Methods: Plasma samples from normotensive pregnant women in the first trimester of pregnancy were obtained. The concentrations of TNF-α and IL-6 were determined using ELISA. STBMs were determined by isolating microvesicles in maternal circulation and quantifying the concentration of PLAP using ELISA. Results: TNF-α, IL-6 and STBMs remained at constant levels in weeks 5-10 of gestation. In weeks 11-12 of gestation, TNF-α increased with a decrease in IL-6 and STBMs. Ratio of TNF-α/IL-6 remained constant in weeks 5-6 and significantly increased in weeks 11-12 of gestation. A positive correlation between TNF-α and IL-6 was obtained in weeks 6-10 and a negative correlation in weeks 11-12 of gestation. In addition, a positive correlation between STBMs & TNF-α was obtained and negative correlation between STBMs and IL-6. was observed Conclusion:The relationship between TNF-α/IL-6 and STBMs suggests that syncytiotrophoblast microvesicles may have a role in cytokine production and in the maintenance of the Th1/Th2 immune adaptation in normal pregnancy.

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