“Trophoblast islands of the chorionic connective tissue” (TICCT): A novel placental histologic feature

Abstract

Introduction We found isolated or clustered trophoblasts in the chorionic connective tissue of the extraplacental membranes, and defined this novel histologic feature as the “trophoblast islands of the chorionic connective tissue” (TICCT). This study was conducted to determine the clinical significance of TICCT. Methods Immunohistochemistry for cytokeratin-7 was performed on the chorioamniotic membranes (N=2155) obtained from singleton pregnancies of 1199 uncomplicated term and 956 preterm deliveries. The study groups comprised 1236 African-American and 919 Hispanic women. Gestational age ranged from 24+0 weeks to 41+6 weeks. Multiple logistic regression analysis was performed to investigate the magnitude of association between patient characteristics and the presence of TICCT. Results The likelihood of TICCT was significantly associated with advancing gestational age both in term (OR: 1.29, 95% CI: 1.16–1.45, p<0.001) and preterm deliveries (OR: 1.19, 95% CI: 1.07–1.32, p=0.001). Hispanic women were less likely than African-American women to have TICCT across gestation in term (OR: 0.23, 95% CI: 0.18–0.31, p<0.001) and preterm pregnancies (OR: 0.41, 95% CI: 0.29–0.58, p<0.001). Women with a female fetus were significantly more likely to have TICCT than women with a male fetus, in both term (OR: 1.64, 95% CI: 1.28–2.11, p<0.001) and preterm gestations (OR: 2.04, 95% CI: 1.46–2.85, p<0.001). TICCT was 40% less frequent in the presence of chronic placental inflammation [term (OR: 0.60, 95% CI: 0.45–0.81, p=0.001) and preterm gestations (OR: 0.58, 95% CI: 0.40–0.84, p=0.003)] and in parous women at term (OR: 0.60, 95% CI: 0.44–0.81, p=0.001). Conclusions Our findings suggest that the duration of pregnancy, fetal sex, and parity may influence the behavior of extravillous trophoblast and placental mesenchymal cells.

Sexually dimorphic responses to early adversity: Implications for affective problems and autism spectrum disorder

“…It is plausible that evaluation of the placenta will provide clues as to which children are at risk for neurodevelopmental delay. Given compelling sex differences in placental anatomy and physiology, including in the presence of trophoblasts inclusions (Hong et al, 2013), this study further supports the necessity of considering sex specific fetal/placental development to understand which individuals will be at risk for neurodevelopmental or psychiatric disorders.…”

Placental Tissues as Biomaterials in Regenerative Medicine

“…The chorion, the maternal-facing layer, in contact with the maternal decidua, is comprised of three layers: the reticular layer, a basement membrane and a trophoblast layer [ 11 , 14 , 15 ]. The chorion forms a barrier between the fetal environment and the maternal immune system [ 16 , 17 ]. The intermediate layer is a spongey network of collagens and proteoglycans that functions as a physical barrier between the amnion and chorion.…”

“…The reticular layer provides a scaffold for the chorion with a network of fibers and is embedded with mesenchymal cells similar to the fibroblast layer in the amnion [ 31 ]. The basement membrane between the reticular layer and the trophoblasts increases the structural integrity of the chorion by providing cell scaffolding for the trophoblast layer and contributes to the immune privilege of the tissue [ 16 , 32 , 33 ]. The trophoblast layer, the outermost layer of the chorion, consists of trophoblasts, myofibroblasts and macrophages [ 16 ].…”

“…Interleukins present in AF are important for cellular communication and the regulation of inflammation [ 143 – 145 ]. Most research on the proteomic make up of AF comes from pre-term analysis via amniocentesis in the study of biomarkers indicative of spontaneous pre-term delivery and other conditions, such as pre-eclampsia [ 16 ]. Further studies have investigated the AF-MSC secretory profile and their impacts on wound healing, revealing that AF-MSC conditioned media has higher profiles of IL-6, IL-8, VEGF, EGF, and TGF- β that successfully promoted healing pathways in dermal fibroblasts [ 146 ].…”