Angiogenic dysfunction in molar pregnancy.
OBJECTIVE
Molar pregnancy is associated with very early-onset preeclampsia. Since excessive circulating antiangiogenic factors may play a pathogenic role in preeclampsia, we hypothesized that molar placentas produce more antiangiogenic proteins than normal placentas.


METHODS
This retrospective case-control study used a semiquantitative immunohistochemical technique to compare histologic sections of molar placentas to normal controls. Tissue slides were treated with 2 antisera: one recognized the antiangiogenic markers fms-like tyrosine kinase receptor 1 (Flt1) and its soluble form (sFlt1), while the other recognized vascular endothelial marker CD31. Stain intensity was graded from 1+ (strong focal staining) to 4+ (91-100% staining).


RESULTS
Molar placentas (n = 19) showed significantly more staining than controls (n = 16) for Flt/sFlt1 (P < .0001).


CONCLUSIONS
There was a significant difference in Flt1/sFlt1 immunostaining intensity when molar placentas were compared to controls. This supports a hypothesis that the phenotype of preeclampsia in molar pregnancy may result from trophoblasts overproducing at least 1 antiangiogenic protein.
Kanter
David
D
Department of Obstetrics and Gynecology, The Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
Lindheimer
Marshall D
MD
Wang
Eileen
E
Borromeo
Romana G
RG
Bousfield
Elizabeth
E
Karumanchi
S Ananth
SA
Stillman
Isaac E
IE
D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000503:physiopathology*; D007150:Immunohistochemistry; D018919:Neovascularization, Physiologic; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D011247:Pregnancy; D012189:Retrospective Studies; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000032:analysis*
D019408:Platelet Endothelial Cell Adhesion Molecule-1; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1