Differential microscopic finding and glucose transporter 3 expression in terminal chorionic villi among birth weight-discordant twin placentas.
OBJECTIVE
To evaluate differences in microscopic findings and glucose transporter 3 (GLUT3) expression in terminal chorionic villi (TV) among birth weight-discordant twin (BWDT) placentas compared with the birth weight-concordant twin (BWCT) placentas.


METHODS
We retrospectively studied a cohort of 26 BWDT, 10 BWCT, 10 pre-eclampsia singleton and 10 normal singleton pregnancies. Placentas were scored for the percentage of TV, the percentage of TV with syncytial knots, the presence of capillary branching patterns of TV, the capillary to terminal villous ratios, the membranous expression of GLUT3 and the nuclear expression of HIF-1α in trophoblasts and capillary endothelial cells of TV using immunohistochemistry. The clinical characteristics and microscopic findings were analyzed and compared.


RESULTS
BWDT placentas exhibited differential percentages of TV, percentages of TV with syncytial knots, capillary to terminal villous ratios, expression of HIF-1α in capillary endothelial cells and expression of GLUT3 in trophoblasts and capillary endothelial cells of TV among each twin pair compared with BWCT placentas (P=0.003, P=0.022, P=0.037, P=0.007, P=0.046 and P=0.002, respectively). Pre-eclampsia singleton placentas exhibited higher GLUT3 expression in trophoblasts, higher HIF-1α expression in capillary endothelial cells of TV and high capillary to terminal villous ratios compared with normal singleton placentas (P=0.001, P<0.001 and P=0.001, respectively).


CONCLUSIONS
We observed a strong relationship between characteristics of adaptive change to hypoxia (GLUT3 expression, TV and syncytial knotting and higher capillary to terminal villous ratios) and BWDT pregnancy but not BWCT pregnancy.
Department of Obstetrics and Gynecology, Chungnam National University, School of Medicine, Daejeon, Republic of Korea.
Mina
M
Lee
Department of Pathology, Chungnam National University, School of Medicine, Daejeon, Republic of Korea.
Song-Yi
SY
Choi
Department of Obstetrics and Gynecology, Chungnam National University Hospital, Daejeon, Republic of Korea.
Byung-Hun
BH
Kang
Department of Obstetrics and Gynecology, Chungnam National University Hospital, Daejeon, Republic of Korea.
Heon-Jong
HJ
Yoo
Department of Obstetrics and Gynecology, Chungnam National University Hospital, Daejeon, Republic of Korea.
Soo-Youn
SY
Song
Department of Pathology, Chungnam National University, School of Medicine, Daejeon, Republic of Korea.
In-Ock
IO
Seong
Department of Pathology, Chungnam National University, School of Medicine, Daejeon, Republic of Korea.
Kwang-Sun
KS
Suh
Department of Pathology, and Cancer Research Institute, Chungnam National University, School of Medicine, Daejeon, Republic of Korea. phone330@cnu.ac.kr.
Kyung-Hee
KH
Kim
D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D002824:Chorionic Villi / Q000378:metabolism*; D015193:Chorionic Villi Sampling; D015331:Cohort Studies; D042783:Endothelial Cells / Q000378:metabolism; D004730:Endothelium, Vascular / Q000378:metabolism; D005260:Female; D051274:Glucose Transporter Type 3 / Q000096:biosynthesis* / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D007231:Infant, Newborn; D010920:Placenta / Q000378:metabolism*; D011225:Pre-Eclampsia; D011247:Pregnancy; D012189:Retrospective Studies; D014327:Trophoblasts / Q000378:metabolism; D014427:Twins
D051274:Glucose Transporter Type 3; C495687:SLC2A3 protein, human