title: Fetoscopic laser coagulation of intertwin anastomoses reduces discordant placental autophagic activities in discordant twin growth.
abstract: OBJECTIVE
  To investigate placental autophagic activity in cases of twin-twin transfusion syndrome (TTTS) after successful laser therapy and to evaluate the effect of intertwin anastomoses on discordant placenta autophagic activity in monochorionic twins with one twin exhibiting selective intrauterine growth restriction.
  
  
  METHODS
  Placenta samples were prospectively obtained from 11 cases of successful TTTS post-laser therapy with two living babies. Among these infants, five infants had selective intrauterine growth restriction (sIUGR), based on the definition of a birth weight below the 10(th) percentile. After protein extraction, western blot tests were used to determine the amount of placenta microtubule-associated protein 1A/1B-light chain 3 (LC3)-II protein in the two individual placenta territories of the twin pair. The LC3-II protein fold change ratio (FCR) in a twin pair was defined as the LC3-II protein fold value over β-actin of the smaller twin divided by the LC3-II protein fold value over β-actin of the larger twin.
  
  
  RESULTS
  The LC3-II FCRs were not significantly different between TTTS with sIUGR and TTTS without sIUGR, after successful laser therapy.
  
  
  CONCLUSIONS
  The discordance of placenta autophagic activity in the monochorionic twin with sIUGR was reduced after laser coagulation of the intertwin anastomoses, which may result from the effect of correction of the discordant intertwin placenta perfusion.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC. Electronic address: j12054@cgmh.org.tw.
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors.forename: Tzu-Hao
authors.initials: TH
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors.forename: Shuenn-Dyh
authors.initials: SD
authors.lastname: Chang
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors.forename: An-Shine
authors.initials: AS
authors.lastname: Chao
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors.forename: Peter C C
authors.initials: PC
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D001343:Autophagy; D001724:Birth Weight; D015153:Blotting, Western; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000601:surgery*; D005330:Fetofetal Transfusion / Q000175:diagnosis / Q000196:embryology / Q000601:surgery*; D005332:Fetoscopy / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D010920:Placenta / Q000196:embryology / Q000473:pathology* / Q000601:surgery; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014427:Twins
keywords: LC3; autophagy; monochorionic twin; placenta; twin-twin transfusion syndrome