title: Uterine spiral artery remodeling involves endothelial apoptosis induced by extravillous trophoblasts through Fas/FasL interactions.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  Extravillous trophoblast induction of endothelial apoptosis is a possible mechanism by which the endothelium is removed, and vascular remodeling may occur in uterine spiral arteries. Fas/FasL interactions have an important role in trophoblast-induced endothelial apoptosis.
authors.affiliation: Biochemistry and Immunology Department of Basic Medical Sciences, St. George's Hospital Medical School, Cranmer Terrace, London, UK.
authors.forename: Sandra V
authors.initials: SV
authors.lastname: Ashton
authors.forename: Guy St J
authors.initials: GS
authors.lastname: Whitley
authors.forename: Philip R
authors.initials: PR
authors.lastname: Dash
authors.forename: Mark
authors.initials: M
authors.lastname: Wareing
authors.forename: Ian P
authors.initials: IP
authors.lastname: Crocker
authors.forename: Philip N
authors.initials: PN
authors.lastname: Baker
authors.forename: Judith E
authors.initials: JE
authors.lastname: Cartwright
mesh_terms: D017209:Apoptosis / Q000502:physiology*; D001158:Arteries / Q000378:metabolism* / Q000473:pathology; D002478:Cells, Cultured; D042783:Endothelial Cells / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology; D053222:Fas Ligand Protein; D005260:Female; D006801:Humans; D008562:Membrane Glycoproteins / Q000378:metabolism*; D014327:Trophoblasts / Q000378:metabolism*; D014599:Uterus / Q000098:blood supply*; D019014:fas Receptor / Q000378:metabolism*
chemical_list: C505661:FASLG protein, human; D053222:Fas Ligand Protein; D008562:Membrane Glycoproteins; D019014:fas Receptor