ASSOCIATION OF SPIRAL ARTERY REMODELING AND VITAMIN D RECEPTORS (VDR) IN PREECLAMPSIA
Main Article Content
Keywords
Placenta, Preeclampsia, Spiral artery, VDR, Vitamin D deficiency
Abstract
Objective: This study is intended to conclude the vitamin D status and VDR gene, with its relation in spiral artery remodeling in normal and pre eclamptic women.
Study Design: Cross-sectional study.
Place and Duration: This study was conducted in Department of Anatomy with collaboration of Department of Gynecology and Obstetrics of Liaquat University Hospital Hyderabad and Jamshoro from August 2021 to July 2022.
Methodology: After ethical approval vide letter (LUMHS/REC/632) total 122 women; of 20-40 years of age with full term, singleton pregnancy, 61from normal-term pregnancies as controls and 61 from preeclampsia were registered at labor room of OBG. After demographic data with septic measures maternal blood sample of 5cc was collected before delivery for assessment of VD and their placentae were collected from labor room immediately after delivery along with 5cm of umbilical cord attached to it. After morphological examination of placenta, sectioning of placenta was performed for microscopic examination. Standard protocol for H &E and immunohistochemistry for VDR were followed performed. Sections were viewed under light microscope and Image J software was used for analysis.
Results: Mean±SD of maternal age, parity and gestational age (in weeks), wall thickness of spiral artery and % of VDR positive cells of study participants were 32.7 years±5.9, 3.9±1.4, 37.3±3.6, 48.11±23.5295 and , 46.49±18.779 respectively. (table1). Mean and SD of vitamin D levels and placental weight (table2) and wall thickness of spiral artery and % of VDR positive stained cells when compared on Image J software between normal and preeclamptic patients is highly significant(table 3).
Conclusions: Abnormal remodeling of spiral artery is significantly associated with low levels of Vitamin D and its receptors, leading to placental diseases such as preeclampsia.
References
2. Akshara VR, R. P., Chitra S, Sailesh KS, Kumar S, Valsalan SE. 2018; 29 (18): 3522-3525 (2018). "Morphology and the morphometric measurements of hypertensive and normotensive placenta." Biomedical Research 29(18): 3522-3525.
3. Ali AM, A. A., Malhis TN, Khattab AF. (2018). "Effect of vitamin D3 supplementation in pregnancy on risk of pre‐eclampsia‐Randomized controlled trial. ." Clin Nutr.
4. Ali AM, R. M., Saleem Z. (2021). "Association of vitamin D deficiency to the risk of preeclampsia in Saudi Arabia. ." JPMA 71(1B): 257-261.
5. Baloch GKR, K. B., Siddiqui RA, Borges KJJ, Shah SNN, Inayatullah, et al . (2021). "Quantitative morphometric analysis of uterine spiral artery in normal and preeclamptic placentae via fluorescence microscopy." JPUMHS; 01: 73-79.
6. Bodnar L.M., S. H. N., Catov J.M., Roberts J.M., Platt R.W., Diesel J.C., Klebanoff M.A. (2014). "Maternal vitamin D status and the risk of mild and severe preeclampsia. ." Epidemiology. 25: 207-214.
7. Bokhari ZH, K. A., Tazeen N, Bukhari MH. (2010). "Histomorphometric study of maternal side of placenta in preeclampsia." Annals of King Edward Medical University. 16(3): 209.
8. Cao, Y., X. Jia, Y. Huang, J. Wang, C. Lu, X. Yuan, J. Xu and H. Zhu (2021). "Vitamin D stimulates miR-26b-5p to inhibit placental COX-2 expression in preeclampsia." Sci Rep 11(1): 11168.
9. Dutta A, S. R., Chatterjee K, Kothari S, Rahaman SR, Sen S. (2017). "Placental damages from ultrasonic changes to histopathological findings in maturing placenta in pregnancy complicated with hypertension: an observational clinical study. ." International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 6(5): 1834-1834.
10. Espinoza, J., R. Romero, Y. Mee Kim, J. P. Kusanovic, S. Hassan, O. Erez, F. Gotsch, N. G. Than, Z. Papp and C. Jai Kim (2006). "Normal and abnormal transformation of the spiral arteries during pregnancy." J Perinat Med 34(6): 447-458.
11. Feldman, A. T. and D. Wolfe (2014). "Tissue processing and hematoxylin and eosin staining." Methods Mol Biol 1180: 31-43.
12. Fulawka L, H. A. (2016). " Proliferation index evaluation in breast cancer using imagej and immunoratio applications. ." Anticancer research 36: 3965-3972.
13. Goswami., P., H. Lata., S. Memon. and L. Khaskhelli., B., (2012). "Excessive Placental Calcification Observed in PIH Patients and its Relation to Fetal Outcome. ." JLUMHS 11(3): 144-148.
14. Heyden, E. L. and S. J. Wimalawansa (2018). "Vitamin D: Effects on human reproduction, pregnancy, and fetal well-being." J Steroid Biochem Mol Biol 180: 41-50.
15. Hollis BW, W. C. (2017). "New insights into the vitamin D requirements during pregnancy. ." Bone Res.
16. Hutabarat, M., N. Wibowo, B. Obermayer-Pietsch and B. Huppertz (2018). "Impact of vitamin D and vitamin D receptor on the trophoblast survival capacity in preeclampsia." PLoS One 13(11): e0206725.
17. Hutchinson, K., M. Healy, V. Crowley, M. Louw and Y. Rochev (2017). "Verification of Abbott 25-OH-vitamin D assay on the architect system." Pract Lab Med 7: 27-35.
18. Karras, S. N., C. L. Wagner and V. D. Castracane (2018). "Understanding vitamin D metabolism in pregnancy: From physiology to pathophysiology and clinical outcomes." Metabolism 86: 112-123.
19. Knabl, J., A. Vattai, Y. Ye, J. Jueckstock, S. Hutter, F. Kainer, S. Mahner and U. Jeschke (2017). "Role of Placental VDR Expression and Function in Common Late Pregnancy Disorders." Int J Mol Sci 18(11).
20. Midhet F, H. N. (2009). "Risk factors of maternal mortality in Pakistan: Preliminary results from the Demographic and Health Survey (DHS), 2006-2007."
21. Palacios, C., L. M. De-Regil, L. K. Lombardo and J. P. Pena-Rosas (2016). "Vitamin D supplementation during pregnancy: Updated meta-analysis on maternal outcomes." J Steroid Biochem Mol Biol 164: 148-155.
22. Pospechova, K., V. Rozehnal, L. Stejskalova, R. Vrzal, N. Pospisilova, G. Jamborova, K. May, W. Siegmund, Z. Dvorak, P. Nachtigal, V. Semecky and P. Pavek (2009). "Expression and activity of vitamin D receptor in the human placenta and in choriocarcinoma BeWo and JEG-3 cell lines." Mol Cell Endocrinol 299(2): 178-187.
23. Roberts, V. H., J. E. Gaffney, K. S. Lewandowski, M. C. Schabel, T. K. Morgan and A. E. Frias (2019). "A standardized method for collection of human placenta samples in the age of functional magnetic resonance imaging." Biotechniques 67(2): 45-49.
24. Serrano NC, G. E., Quintero‐Lesmes DC, et al. (2018). "Vitamin D deficiency and pre‐eclampsia in Colombia: PREVitD study. ." Pregnancy Hypertens.
25. Shamsi U, S. S., Nishter N. (2013). "Epidemiology and risk factors of preeclampsia; an overview of observational studies. ." Al Ameen J Med Sci 6(4).
26. Shevade S, A. V., Bharambe V, Paranjape V. (2015). "Placental morphology and fetal outcome in preeclampsia and normotensive pregnancies. ." iOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 1(14): 11-15.
27. SS., H. (2021). "Complication of gestational preeclampsia and the differences between tunica media and internal area of spiral artery by image j. ." PJ M H S 15(3): 1093-1097.
28. TW., S. (2015). Langman's Text Book of Embryology.
29. Umar, N., A. Tauseef, F. Shahzad, S. Sabir, S. Kanwal, A. Akmal and S. Zulfiqar (2016). "Serum 25-Hydroxy Vitamin D Level in Preeclamptic and Normotensive Pregnancies." J Coll Physicians Surg Pak 26(8): 673-676.
30. Vijayalakshmi B, K. S. (2015). ""Morphological Changes of Placenta in Cases of Pre-eclampsia and Perinatal Outcome." " Int J Sci Stud, 3: 137-142.
31. Wubale Y, T. A. (2017). " Gross morphological study of placenta in preeclampsia." Anatomy Journal of Africa. 6(2): 977-981.