Interaction of histological events and physiological mediators in healthy placentas from malaria-endemic area in Colombia: An approach with a factorial model
Abstract
The biological study of the placenta is fragmented and focused on morbid events. The interaction of histological events and mediators of physiological processes in healthy placentas in malaria-endemic areas is unknown. This study aimed to build a factorial model for the convergence of events and mediators in healthy placentas of women living in northwestern Colombia through a study of 44 placentas. Linear correlations and exploratory factor analysis were carried out with histological events and expression of genes related to mediators. The factor analysis allowed us the identification of three components. The first compound by the following histological variables: number of capillaries and villus, immune cells in villus, atherosis, and CD8+ lymphocytes. The second with articulation of histological variables (syncytyal nodes, fibrinoid deposits, thrombi and immune cells) and physiological mediators of apoptosis and regulation. The thirth included physiological mediators of hypoxia, angiogenesis, pro-inflammation and anti-inflammation. All components presented excellent predictive and construct validity, and excellent goodness of fit parameters. In healthy placentas, the factorial structure of histological events and physiological mediators in three underlying components that support their interactions was demonstrated. These findings are significant because they help improve the study of healthy placental biology in malaria endemic areas and evaluate mechanisms that alter its morphology and function, with their subsequent risk for pregnancy and maternal-fetal health. (Afr J Reprod Health 2022; 26[11]: 91-104).
Full Text:
PDFReferences
Burton GJ and Jauniaux E. What is the placenta? Am J Obstet Gynecol. 2015;213(4 Suppl):S6.e1, S6-8. doi: 10.1016/j.ajog.2015.07.050. PMID: 26428504.
Turco MY and Moffett A. Development of the human placenta. Development. 2019;146(22):dev163428. doi: 10.1242/dev.163428. PMID: 31776138.
Costa ML, de Moraes Nobrega G and Antolini-Tavares A. Key Infections in the Placenta. Obstet Gynecol Clin North Am. 2020;47(1):133-146. doi: 10.1016/j.ogc.2019.10.003.
Maltepe E and Fisher SJ. Placenta: the forgotten organ. Annu Rev Cell Dev Biol. 2015; 31:523-52. doi: 10.1146/annurev-cellbio-100814-125620.
Iacovelli A, Liberati M, Khalil A, Timor-Trisch I, Leombroni M, Buca D, Milani M, Flacco ME, Manzoli L, Fanfani F, Calì G, Familiari A, Scambia G and D'Antonio F. Risk factors for abnormally invasive placenta: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2020; 33(3):471-481. doi: 10.1080/14767058.2018.1493453.
Reijnders IF, Mulders AGMGJ and Koster MPH. Placental development and function in women with a history of placenta-related complications: a systematic review. Acta Obstet Gynecol Scand. 2018;97(3):248-257. doi: 10.1111/aogs.13259.
Huppertz B. The anatomy of the normal placenta. J Clin Pathol. 2008; 61(12):1296-302. doi: 10.1136/jcp.2008.055277.
Morales-Vallejo P. El Análisis Factorial en la construcción e interpretación de tests, escalas y cuestionarios. [Internet] 2011; [citado 2020 oct. 16]. Disponible en: http://www.upcomillas.es/personal/peter/investigacion/AnalisisFactorial.pdf.
Zamora-Muñoz S, Monroy-Cazorla L and Chávez-Álvarez C. Análisis factorial: una técnica para evaluar la dimensionalidad de las pruebas. Cuaderno técnico 6. México DF: Centro Nacional de Evaluación para la Educación Superior (Ceneval), 2009.
Dobaño C, Bardají A, Kochar S, Kochar SK, Padilla N, López M, Unger HW, Ome-Kaius M, Castellanos ME, Arévalo-Herrera M, Hans D, Martínez-Espinosa FE, Bôtto-Menezes C, Malheiros A, Desai M, Casellas A, Chitnis CE, Rogerson S, Mueller I, Menéndez C and Requena P. Blood cytokine, chemokine and growth factor profiling in a cohort of pregnant women from tropical countries. Cytokine. 2020;125:154818. doi: 10.1016/j.cyto.2019.154818.
López-Guzmán C and Carmona-Fonseca J. Malaria placentaria submicroscópica: histopatología y expresión de mediadores de procesos fisiológicos. Rev Peru Med Exp Salud Pub. 2020;37(2):220-8. doi: https://doi. org/10.17843/rpmesp.2020.372.4759.
Carmona-Fonseca J. La Región “Urabá Antioqueño-Cuencas altas de los ríos Sinú y San Jorge-Bajo Cauca antioqueño”: “guarida” del paludismo colombiano. Rev Univ Ind Santander Salud. 2017; 49(4): 577-589. doi: http://dx.doi.org/10.18273/revsal.v49n4-2017007.
Langston C, Kaplan C, Macpherson T, Manci E, Peevy K, Clark B, Murtagh C, Cox S and Glenn G. Practice guideline for examination of the placenta. Developed by the Placental Pathology Practice Guideline. Development Task Force of the College of American Pathologists. Arch Pathol Lab Med. 1997; 121:449-76.
Botella Llusiá J. La placenta. Fisiología y patología. 1 edn. Madrid, 1992.
Fox H and Sebire NJ. Pathology of the Placenta-Major Problems in Pathology. 3rd edition. China: Saunders-Elsevier, 2007.
Baergen R. Manual of Pathology of the Human Placenta. 2nd edition edn. New York, 2011.
Redline RW. Classification of placental lesions. Am J Obstet Gynecol 2015, 213:S21-28.
Khong TY, Mooney EE, Ariel I, Balmus NC, Boyd TK, Brundler MA, Derricott H, Evans MJ, Faye-Petersen OM, Gillan JE, Derricott H, Evans MJ, Faye-Petersen OM, Gillan JE, Heazell AE, Heller DS, Jacques SM, Keating S, Kelehan P, Maes A, McKay EM, Morgan TK, Nikkels PG, Parks WT, Redline RW, Scheimberg I, Schoots MH, Sebire NJ, Timmer A, Turowski G, van der Voorn JP, van Lijnschoten I and Gordijn SJ. Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement. Arch Pathol Lab Med. 2016, 140:698-713.
Aplin JD, Beristain A, DaSilva-Arnold S, Dunk C, Duzyj C, Golos TG, Kemmerling U, Knöfler M, Mitchell MD, Olson DM, Petroff M, Pollheimer J, Reyes L, Schedin P, Soares MJ, Stencel-Baerenwald J, Thornburg KL and Lash GE. IFPA meeting 2016 workshop report III: Decidua-trophoblast interactions; trophoblast implantation and invasion; immunology at the maternal-fetal interface; placental inflammation. Placenta 2017, 60 Suppl 1:S15-S19.
Staff AC, Dechend R and Pijnenborg R. Learning from the placenta: acute atherosis and vascular remodeling in preeclampsia-novel aspects for atherosclerosis and future cardiovascular health. Hypertension. 2010, 56:1026-1034.
Reyna-Villasmil E, Santos-Bolívar J and Suárez-Torres I. Microparticles in pregnancy and preeclampsia. Rev Obstet Ginecol Venezuela. 2013, 73(4):268-276.
Castejón O, Ali S and Canache L. El edema de la vellosidad placentaria en los casos de muerte fetal. Gaceta Médica de Caracas. 2006; 114(4):291-299.
Castejón O, López A, Péres L and Castejón O. Presencia de alteraciones histopatológicas en vellosidades placentarias normales en Maracay (Venezuela). Revista Colombiana de Obstetricia y Ginecología. 2009; 60(3):237-246.
Prieto-Gómez R, Ottone N, Sandoval-Vásquez C, Saavedra A and Bianchi H. Morphoquantitative Characteristics of Free Corial Vellosities in Normal Births, with Diabetes, Hypertension and Restriction of Intrauterine Growth. Int J Morphol, 2018;36(2):551-556.
Coleman SJ, Gerza L, Jones CJ, Sibley CP, Aplin JD and Heazell AE. Syncytial nuclear aggregates in normal placenta show increased nuclear condensation, but apoptosis and cytoskeletal redistribution are uncommon. Placenta. 2013, 34:449-455.
Corrêa RR, Gilio DB, Cavellani CL, Paschoini MC, Oliveira FA, Peres LC, Reis MA, Teixeira VP and Castro EC. Placental morphometrical and histopathology changes in the different clinical presentations of hypertensive syndromes in pregnancy. Arch Gynecol Obstet. 2008, 277:201-206.
Heazell AE, Moll SJ, Jones CJ, Baker PN and Crocker IP. Formation of syncytial knots is increased by hyperoxia, hypoxia and reactive oxygen species. Placenta. 2007, 28 Suppl A:S33-40.
Scifres CM and Nelson DM. Intrauterine growth restriction, human placental development and trophoblast cell death. J Physiol. 2009, 587:3453-3458.
Apaza-Valencia J. Desarrollo placentario temprano: aspectos fisiopatológicos. Rev peru ginecol obstet. 2014; 60(2):131-140.
Loukeris K, Sela R and Baergen RN. Syncytial knots as a reflection of placental maturity: reference values for 20 to 40 weeks' gestational age. Pediatr Dev Pathol. 2010, 13:305-309.
Isaza-Mejía G, Yepes-Zapata G and Castaño M. Arquitectura histológica de la placenta humana al contraste de fases y aplicaciones clínicas. Rev Col Obst y Ginec. 1971; 22(1). Doi: https://doi.org/10.18597/rcog.1273.
Chaikitgosiyakul S, Rijken MJ, Muehlenbachs A, Lee SJ, Chaisri U, Viriyavejakul P, Turner GD, Pongponratn E, Nosten F and McGready R. A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection. Malar J. 2014; 13:4.
Cohee LM, Kalilani-Phiri L, Boudova S, Joshi S, Mukadam R, Seydel KB, Mawindo P, Thesing P, Kamiza S, Makwakwa K, Muehlenbachs A, Taylor TE and Laufer MK. Submicroscopic malaria infection during pregnancy and the impact of intermittent preventive treatment. Malar J. 2014; 13:274.
Merz G, Schwenk V, Shah R, Salafia C, Necaise P, Joyce M, Villani T, Johnson M and Crider N. Three-dimensional Rendering and Analysis of Immunolabeled, Clarified Human Placental Villous Vascular Networks. J Vis Exp. 2018; (133):57099. doi: 10.3791/57099.
Prieto-Gómez R, Matamala F and Rojas M. Características morfológicas y morfométricas de la placenta de término, en recién nacidos pequeños para la edad gestacional (PEG) en la ciudad de Temuco-Chile. Int J Morphol. 2008, 26:615-621.
Castejón O, Belouche R and Morett V. El proceso de calcificación en la placenta humana. Gac méd Caraca.s 1998, 106(4):496-501.
Bulmer JN, Williams PJ and Lash GE. Immune cells in the placental bed. Int J Dev Bio.l 2010, 54:281-294.
Sanguansermsri D and Pongcharoen S. Pregnancy immunology: decidual immune cells. Asian Pac J Allergy Immunol. 2008, 26:171-181.
Ortega-Pajares A and Rogerson SJ. The Rough Guide to Monocytes in Malaria Infection. Front Immunol. 2018, 9:2888.
Image J 1.46r. Wayne Rasband National Institutes of Health, USA, https://imagej.nih.gov/ij/index.html. Accessed 15 Jan 2021.
Pfaffl MW. A new mathematical model for relative quantification in real-time RT-PCR. Nucleic Acids Res. 2001;29(9):e45. doi: 10.1093/ nar/29.9.e45.
Dawson-Saunders B and Trapp RG. Bioestadística médica. México DF: El Manual Moderno, 1993.
SPSS. Análisis estadístico avanzado con IBM® SPSS Statistics. Análisis factorial. SPSS Andino: Infórmese Ltda, 2006. p. 162-182.
Byrne B. Structural equation modeling with AMOS, basic concepts, applications, and programming. New York: Routledge, Taylor & Frances Group, 2010.
Sharma A and Rudra D. Emerging Functions of Regulatory T Cells in Tissue Homeostasis. Front Immunol. 2018; 9:883. doi: 10.3389/fimmu.2018.00883.
Drake PM, Gunn MD, Charo IF, Tsou CL, Zhou Y, Huang L and Fisher SJ. Human placental cytotrophoblasts attract monocytes and CD56(bright) natural killer cells via the actions of monocyte inflammatory protein 1alpha. J Exp Med. 2001; 193(10):1199-212. doi: 10.1084/jem.193.10.1199.
Hung TH, Huang SY, Chen SF, Wu CP and Hsieh TT. Decreased placental apoptosis and autophagy in pregnancies complicated by gestational diabetes with large-for-gestational age fetuses. Placenta. 2020; 90:27-36. doi: 10.1016/j.placenta.2019.12.003.
Raguema N, Moustadraf S and Bertagnolli M. Immune and apoptosis mechanisms regulating placental development and vascularization in preeclampsia. Front Physiol. 2020;11:98. doi: 10.3389/fphys.2020.00098.
Noyola-Martínez N, Díaz L, Zaga-Clavellina V, Avila E, Halhali A, Larrea F and Barrera D. Regulation of CYP27B1 and CYP24A1 gene expression by recombinant pro-inflammatory cytokines in cultured human trophoblasts. J Steroid Biochem Mol Biol. 2014; 144 Pt A:106-9. doi: 10.1016/j.jsbmb.2013.12.007.
Cervantes-Villagrana RD, Cervantes-Villagrana AR and Presno-Bernal JM. Mecanismos de señalización involucrados en la resolución de la inflamación. Gaceta Médica de México. 2014; 150:440-9.
Delves PJ, Martin SJ, Burton DR and Roitt IM. Roitts´s Essential Immunology. 13 ed. Wiley Blackwell, 2017.
Abbas AK, Pillai S and Lichtman AH. Basic Immunology. Functions and Disorders of the Immune System. China: Elsevier, 2020.
Wegmann TG, Lin H, Guilbert L and Mosmann TR. Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a TH2 phenomenon? Immunol Today. 1993;14(7):353-6. doi: 10.1016/0167-5699(93)90235-D.
Chatterjee P, Chiasson VL, Bounds KR and Mitchell BM. Regulation of the Anti-Inflammatory Cytokines Interleukin-4 and Interleukin-10 during Pregnancy. Front Immunol. 2014;5:253. doi: 10.3389/fimmu.2014.00253.
Barañao R. Inmunología del embarazo. Invest. clín. 2011; 52(2):175-194.
Reyna-Villasmil E, Briceño-Pérez C and Torres-Cepeda D. Vasculogénesis y angiogénesis durante el embarazo normal y en la preeclampsia. Rev Obstet Ginecol Venez. 2010;70(4):265-279.
Macholdová K, Macháčková E, Prošková V, Hromadníková I and Klubal R. Latest findings on the placenta from the point of view of immunology, tolerance and mesenchymal stem cells. Ceska Gynekol. 2019; 84(2):154-160.
Kraus TA, Sperling RS, Engel SM, Lo Y, Kellerman L, Singh T, Loubeau M, Ge Y, Garrido JL, Rodríguez-García M and Moran TM. Peripheral blood cytokine profiling during pregnancy and post-partum periods. Am. J. Reprod. Immunol. 2010; 64:411–426, https://doi.org/10.1111/j.1600-0897.2010.00889.x.
Hanna N, Hanna I, Hleb M, Wagner E, Dougherty J, Balkundi D, Padbury J and Sharma S. Gestational age-dependent expression of IL-10 and its receptor in human placental tissues and isolated cytotrophoblasts. J. Immunol. 2000; 164(11):5721–5728. doi: 10.4049/jimmunol.164.11.5721.
Stokkeland LMT, Giskeødegard GF, Stridsklev S, Ryan L, Steinkjer B, Tangeras LH, Vanky E and Iversen AC. Serum cytokine patterns in first half of pregnancy. Cytokine. 2019; 119:188–196, doi: 10.1016/j.cyto.2019.03.013.
Mir IN, Chalak LF, Liao J, Johnson-Welch S, Brown LS, Longoria S, Savani RC and Rosenfeld CR. Fetal-placental crosstalk occurs through fetal cytokine synthesis and placental clearance. Placenta. 2018; 69:1–8. doi: 10.1016/j.placenta.2018.07.006.
Unal ER, Cierny JT, Roedner C, Newman R and Goetzl L. Maternal inflammation in spontaneous term labor. Am J Obstet Gynecol. 2011;204(3):223.e1-5. doi: 10.1016/j.ajog.2011.01.002.
Tong M and Abrahams VM. Immunology of the Placenta. Obstet Gynecol Clin North Am. 2020; 47(1):49-63. doi: 10.1016/j.ogc.2019.10.006. PMID: 32008671.
Refbacks
- There are currently no refbacks.