Decidual spiral artery remodelling begins before cellular interaction with cytotrophoblasts

Craven, Catherine; Morgan, Terry K.; Ward, Kenneth

doi:10.1016/s0143-4004(98)90055-8

Cited by 255 publications

(168 citation statements)

References 18 publications

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“…This is the most comprehensive report of decidual vascular remodeling to date and extends previous observations of subtle trophoblastindependent vascular remodeling. 10 These observations provide strong correlative evidence that immune cells of the decidua could play a pivotal transient role in vascular remodeling. A role for uNK cells in spiral artery remodeling has been hypothesized, 16,27 but never established in the human.…”

Section: Discussionmentioning

confidence: 75%

“…Early signs of transformation, including VSMC hypertrophy, endothelial basophilia, and vasodilatation, are detectable in the absence of invading EVT, in intrauterine decidual samples from tubal pregnancies and late secretory phase endometrium from curettage or early terminations. 10 These changes have been designated decidualization-associated vascular remodeling 11 and suggest the participation of maternally derived factors in the early preparatory events. In the mouse, elegant studies have demonstrated a definitive role for maternal leukocytes in mediating trophoblastindependent vascular remodeling.…”

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confidence: 99%

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Evidence for Immune Cell Involvement in Decidual Spiral Arteriole Remodeling in Early Human Pregnancy

Smith

Dunk

Aplin

et al. 2009

The American Journal of Pathology

405

381

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Decidual artery remodeling is essential for a healthy pregnancy. This process involves loss of vascular smooth muscle cells and endothelium, which are replaced by endovascular trophoblasts (vEVTs) embedded in fibrinoid. Remodeling is impaired during preeclampsia, a disease of pregnancy that results in maternal and fetal mortality and morbidity. Early vascular changes occur in the absence of vEVTs, suggesting that another cell type is involved; evidence from animal models indicates that decidual leukocytes play a role. We hypothesized that leukocytes participate in remodeling through the triggering of apoptosis or extracellular matrix degradation. Decidua basalis samples (8 to 12 weeks gestation) were examined by immunohistochemistry to elucidate associations between leukocytes, vEVTs, and key remodeling events. Trophoblast-independent and -dependent phases of remodeling were identified. Based on a combination of morphological attributes, vessel profiles were classified into a putative temporal series of four stages. In early stages of remodeling, vascular smooth muscle cells showed dramatic disruption and disorganization before vEVT presence. Leukocytes (identified as uterine natural killer cells and macrophages) were apparent infiltrating vascular smooth muscle cells layers and were matrix metalloproteinase-7 and -9 immunopositive. A proportion of vascular smooth muscle cells and endothelial cells were terminal deoxynucleotidyl transferase dUTP nick-end labeling positive, suggesting remodeling involves apoptosis. We thus confirm that vascular remodeling occurs in distinct trophoblast-independent and -dependent stages and provide the first evidence of decidual leukocyte involvement in trophoblastindependent stages.

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Section: Discussionmentioning

confidence: 75%

mentioning

confidence: 99%

Evidence for Immune Cell Involvement in Decidual Spiral Arteriole Remodeling in Early Human Pregnancy

Smith

Dunk

Aplin

et al. 2009

The American Journal of Pathology

405

381

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show abstract

“…86 Trophoblastic invasion of spiral arteries had been initially suggested as the primary mechanism responsible for the transformation of the spiral arteries. Observations in intrauterine decidual samples from tubal pregnancies and early terminations, however, showed that early vascular changes occur in the absence of invading trophoblasts, 87 indicating that other cell populations are also involved. Studies in human decidua basalis samples demonstrated that vascular infiltration of spiral arteries by natural killer cells and decidual macrophages precedes trophoblastic invasion.…”

Section: Uterine Arterial Adaptations and Responses In Preeclampsia Smentioning

confidence: 99%

Maternal Vascular Physiology in Preeclampsia

Goulopoulou

2017

Hypertension

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“…Recently a role for uNK cells in trophoblast independent spiral artery remodelling has been proposed (Pijnenborg et al, 2006). Although complete remodelling ('transformation') of uterine spiral arteries requires a contribution from trophoblast (Kam et al, 1999), the initial stages of spiral artery remodelling, including dilatation, some fibrinoid deposition and vascular smooth muscle cell separation appear to occur in the absence of extravillous trophoblast cells (Figure 2) (Craven et al, 1998;Kam et al, 1999). Uterine NK cells are frequently aggregated around the spiral arteries in early pregnancy; rather than reflecting their trafficking from blood, this distribution may reflect a role in mediating vascular changes in pregnancy.…”

Section: Functional Investigationsmentioning

confidence: 99%