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Objective-Invasion of uterine spiral arteries by extravillous trophoblasts in the first trimester of pregnancy results in loss of endothelial and musculoelastic layers. This remodeling is crucial for an adequate blood supply to the fetus with a failure to remodel implicated in the etiology of the hypertensive disorder preeclampsia. The mechanism by which trophoblasts induce this key process is unknown. This study gives the first insights into the potential mechanisms involved. Methods and Results-Spiral arteries were dissected from nonplacental bed biopsies obtained at Caesarean section, and a novel model was used to mimic in vivo events. Arteries were cultured with trophoblasts in the lumen, and apoptotic changes in the endothelial layer were detected after 20 hours, leading to loss of endothelium by 96 hours. In vitro, coculture experiments showed that trophoblasts stimulated apoptosis of primary decidual endothelial cells and an endothelial cell line. This was blocked by caspase inhibition and NOK2, a FasL blocking antibody. NOK2 also abrogated trophoblast-induced endothelial apoptosis in the vessel model. Key Words: apoptosis Ⅲ endothelium Ⅲ trophoblast Ⅲ pregnancy Ⅲ arteries R emodeling of the uterine arteries is a key event in early pregnancy. In the first trimester of pregnancy, a subpopulation of fetal trophoblast cells, the extravillous trophoblast, invade the uterine wall (interstitial invasion) and its blood vessels (endovascular invasion) as far as the myometrial segments. In the uterine spiral arteries, the trophoblasts interdigitate between the endothelial cells (ECs), replacing the endothelial lining and most of the musculoelastic tissue in the vessel walls. This creates a high-flow, low-resistance circulation that increases maternal blood flow to the placental villi at the maternal-fetal interface. Conclusions-ExtravillousData suggest that trophoblasts bind to and migrate along the luminal surfaces of the endothelium and transiently coexist on the walls of partially modified spiral arteries before replacing the endothelium. 1,2 Little is known as to how these processes are regulated in normal pregnancies; however, their pivotal importance in the establishment and maintenance of a successful pregnancy is illustrated when they fail to occur or occur to a significantly reduced extent. Defective remodeling of the spiral arteries is associated with pregnancies complicated by preeclampsia and intrauterine growth restriction (IUGR) 3 and is proposed to lead to an overall state of oxidative stress or fluctuations in oxygen concentrations analogous to hypoxia-reperfusion within the placental environment. 4 Preeclampsia and IUGR are responsible for considerable perinatal mortality and morbidity and carry health implications in adult life, including increased risk of hypertension, heart disease, and diabetes. 5 The importance of interactions between trophoblasts and the vascular cells of the spiral arteries, which may account for these differences in remodeling, have yet to be determined in normal or compli...

Ror1 and Ror2 are orphan receptor tyrosine kinases that are most closely related to MuSK and the Trk family of neurotrophin receptors. We report the results of an extensive in situ hybridisation survey of the expression of these genes during mouse development. Expression of Ror1 and Ror2 differs markedly at early stages (E8.5--E9.5). At these times, Ror2 is expressed much more widely than Ror1, expression of which is largely restricted to head mesenchyme. At later stages of development (E12.5--E14.5), Ror1 expression expands and Ror2 expression becomes more restricted than at earlier times, although expression of Ror1 continues to be more restricted than that of Ror2. These changes result in overlapping expression domains but with major differences remaining. In many cases Ror1 is expressed in a sub-set of Ror2-expressing tissues; in others, there is complementary expression of Ror1 and Ror2. Ror1 and Ror2 are both expressed in derivatives of all three germ layers and in most organ systems, including the nervous, circulatory, respiratory, digestive, urogenital and skeletal systems. Conspicuous themes are the expression in major sense organs, and in neural crest and its derivatives.

The mechanisms of deficient placentation in the first trimester remain poorly understood, although apoptosis, hypoxia, and oxidative stress have been implicated. High uterine artery Doppler resistance indexes (RIs) are predictive of placental complications of pregnancy, such as preeclampsia, fetal growth restriction, and stillbirth. We provide evidence that even in the first trimester, pregnancies with high uterine artery Doppler RI demonstrate alterations in placental gene and protein expression. Apoptosis was significantly higher in high RI placental tissue, as determined by Western blot analysis of cleaved poly (ADP-ribose) polymerase and caspase 3. Protein expression of the trophoblast survival factor insulin-like growth factor-2 was significantly lower. Both high and normal RI placentas showed evidence of hypoxia and oxidative stress with expression of hypoxia-inducible factors 1α and 2α, heat shock protein 70, presence of nitrotyrosine residues, and lipid peroxidation. We observed no exaggerated placental hypoxia or oxidative stress associated with high RI pregnancies. High RI placental tissue demonstrated an altered balance of antioxidant enzyme activity. Hypoxia and oxidative stress appear to be a physiological state in early pregnancy; our data did not support the hypothesis that they are associated with deficient placentation in the first trimester. Higher levels of apoptosis, reduced insulin-like growth factor-2 expression, and altered antioxidant defenses may contribute to abnormal placentation and the later development of pregnancy complications, such as preeclampsia, fetal growth restriction, and stillbirth.