Placental expression of vimentin, desmin and ultrastructural changes in the villi in patients with HELLP syndrome

M.E. Sak, E. Deveci, A. Turgut, S. Sak, M.S. Evsen, T. Gul, S. Kalkanli

Department of Obstetrics and Gynecology, School of Medicine, Dicle University, Diyarbakir, Turkey. drmesak@yahoo.com

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• Obstetrics

OBJECTIVES: To examine placental expression of vimentin and desmin in relation to ultrastructural changes within the placental villi in cases of HELLP syndrome.

STUDY DESIGN: Formaldehyde-fixed and paraffin-embedded specimens of 15 healthy pregnant and 13 Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, placentas were used for Harris hematoxylin staining, vimentin and desmin immunohistochemistry, and transmission electron microscopy (TEM).

RESULTS: Increased of fibrinoid necrosis in vascular wall and the periphery of villi were observed in sections of the placentas with HELLP syndrome. Increased expression of vimentin in the intravillous area and increased expression of desmin on blood vessel wall, were seen in placentas of patients with HELLP syndrome when compared to placentas of healthy pregnant.

CONCLUSIONS: Augmentation of intermediate filaments, desmin, vimentin may disturb normal movements of endothelial cells, and may display placental dysfunction that is unable to compensate the endothelial instability and the related hypertension in HELLP syndrome. Further studies are needed to get more definit results and also to compare HELLP syndrome with preeclampsia.

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