title: Apoptosis, proliferation and Fas ligand expression in placental trophoblast from pregnancies complicated by HELLP syndrome or pre-eclampsia.
abstract: OBJECTIVE
  To investigate apoptosis, proliferation and Fas ligand expression of placental trophoblast in the hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome and in pre-eclampsia (PE), and to compare this with normal pregnancies.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospital in Croatia.
  
  
  METHODS
  Placentae from women with HELLP syndrome (n=10), PE (n=10) and normal pregnancies (n=10).
  
  
  METHODS
  The HELLP syndrome was diagnosed with platelets <100×10(9) /L, aspartate aminotransferase (AST) and alanine transaminase (ALT) >70 U/L and lactic acid dehydrogenase (LDH) > 600 U/L. Pre-eclampsia was diagnosed at blood pressure >140/90 mmHg, with proteinuria >300 mg/L/24 hours. For detection of apoptosis and proliferation in villous trophoblast, antibodies M30 and Ki-67 were used. Expression of Fas ligand was assessed using immunohistochemistry and the semiquantitative HSCORE method.
  
  
  METHODS
  Apoptosis, proliferation and Fas ligand expression in villous trophoblast.
  
  
  RESULTS
  Apoptosis, proliferation and Fas ligand expression were higher in villous trophoblast in HELLP syndrome than in the PE group (p=0.015, p=0.018 and p=0.002, respectively) and the control group (p=0.000, p=0.012 and p=0.049, respectively). Placentae from the PE group had higher levels of apoptosis (p=0.019), lower Fas ligand expression (p=0.029) and no difference in proliferation (p=0.887) compared with the control group.
  
  
  CONCLUSIONS
  There is an increase in apoptosis, proliferation and Fas ligand expression in placentae from women with HELLP syndrome compared with placentae from PE and normal pregnancies. Our findings indicate the possibility of differential mechanisms behind HELLP syndrome and PE.
authors.affiliation: Department of Pathology, Forensic Medicine and Cytology, Clinical Hospital Centre Split, Spinciceva 1, Split, Croatia. ivanakp@mefst.hr
authors.forename: Ivana Kuzmic
authors.initials: IK
authors.lastname: Prusac
authors.forename: Sandra
authors.initials: S
authors.lastname: Zekic Tomas
authors.forename: Damir
authors.initials: D
authors.lastname: Roje
mesh_terms: D000328:Adult; D017209:Apoptosis; D016022:Case-Control Studies; D049109:Cell Proliferation; D002585:Cesarean Section / Q000379:methods; D053222:Fas Ligand Protein / Q000378:metabolism*; D005260:Female; D017359:HELLP Syndrome / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D010920:Placenta / Q000378:metabolism / Q000473:pathology; D011225:Pre-Eclampsia / Q000473:pathology* / Q000601:surgery; D011247:Pregnancy; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014327:Trophoblasts / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
chemical_list: D053222:Fas Ligand Protein