title: Apoptotic and morphological features of the umbilical artery endothelium in mild and severe pre-eclampsia.
abstract: BACKGROUND
  The pathology of the umbilical arterial endothelium in normal pregnancy and in pregnancy complicated with pre-eclampsia remains unclear. In this study the changes that occur in the umbilical artery endothelial cells were examined and endothelial cell morphology and apoptosis were compared among control, mild, and severe pre-eclamptic subjects.
  
  
  METHODS
  Umbilical cords with a gestational age of between 35 and 40 weeks were collected from women with normal pregnancies (n=17), mild pre-eclampsia (n=10), and severe pre-eclampsia (n=12). We studied the umbilical artery endothelial cells using flow cytometry, and light and electron microscopy. Apoptosis was measured using flow cytometry and the terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end labeling technique. The Kruskall-Wallis variance analysis and Mann-Whitney U-tests as post hoc were applied.
  
  
  RESULTS
  In mild pre-eclamptics, the endothelial cells appeared ultrastructurally separated. A dilated endoplasmic reticulum, swollen mitochondria, and vanished mitochondrial cristae were observed. In severe pre-eclamptics, the cells were disorganized, highly contracted and vacuolated, separated from each other, and protruding prominently into the lumen. The percentages of endothelial cells that underwent apoptosis in mild (p<0.017) and severe pre-eclamptics (p<0.017) were higher than those in the controls. These apoptosis values were highest in severe pre-eclamptics (p<0.0001).
  
  
  CONCLUSIONS
  Apoptosis and structural disruptions in the arterial endothelium of severe pre-eclamptics were prominent in all subjects. Increased endothelial apoptosis and structural disruptions are clinically related to intensity of pre-eclampsia, and may be associated with adaptation of the endothelial cells to pre-eclampsia.
authors.affiliation: Department of Histology and Embryology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey. eyulug@meds.ktu.edu.tr
authors.forename: Esin
authors.initials: E
authors.lastname: Yuluğ
authors.forename: Engin
authors.initials: E
authors.lastname: Yenilmez
authors.forename: Mesut A
authors.initials: MA
authors.lastname: Unsal
authors.forename: Sevim
authors.initials: S
authors.lastname: Aydin
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Tekelioglu
authors.forename: Haluk
authors.initials: H
authors.lastname: Arvas
mesh_terms: D000328:Adult; D017209:Apoptosis; D016022:Case-Control Studies; D003593:Cytoplasm / Q000648:ultrastructure; D018870:Endoplasmic Reticulum, Rough / Q000648:ultrastructure; D004730:Endothelium, Vascular / Q000166:cytology* / Q000473:pathology* / Q000648:ultrastructure; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D005865:Gestational Age; D006801:Humans; D020287:In Situ Nick-End Labeling; D008854:Microscopy, Electron / Q000379:methods; D008928:Mitochondria / Q000648:ultrastructure; D011225:Pre-Eclampsia / Q000473:pathology*; D011247:Pregnancy; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014469:Umbilical Arteries / Q000166:cytology / Q000473:pathology* / Q000648:ultrastructure