Background and aims:We have assumed that decidual maternalexposure to degradation products of blood could activate theinnate immune system in the maternal/fetal interface, throughstimulation of decidual TLRs 2-3-4 and this can lead to placentaabrution. With the objective to evaluate this hypothesis, we havedesigned this prospective double blind study.Methods:Placentas from 12 pregnant patients, came to ouremergency room for suspicion detachment of the placenta, werecollected from the delivery unit of Niguarda Hospital in Milan,Italy (first group). Placentas from 16 normal term pregnanciesFree Communication Presentations64ª2008 The AuthorsªRCOG 2008 BJOG An International Journal of Obstetrics and Gynaecologywho had given birth just before or shortly after of the previouspatients served as physiological controls and were collected. Afteradequate preparation the anti-TLR2 antibody, the anti TLR3antibody and the anti TLR4 antibody have been tested onplacenta with Immunofluorescence technique.Results:This study showed a trend to decidual TLRs 3 activation,compared to the population of physiological control (P= 0.0179).Unlike decidual TLRs 2 and 4 are not activated (P= 0.9779 andP= 0.1671 respectively).Discussion:TLR3, unlike other TLRs, is triggered also from RNAas an endogenous product. It is possible that the TLRs 3 areactivated by the degradation products of blood, while TLR 2 and4 are not activated.Conclusion:From our study is not possible to understand whetherthe activation of TLRs 3 determines the detachment of theplacenta, or if it is the detachment of the placenta that, throughgreater contact between decidual tissue and degradation productsof blood (both maternal and fetal) determines activation of TLRs3. However, the study tells us three important messages for futureresearch: (i) The innate immune system plays an important rolein the genesis of the detachment of the placenta. (ii) The TLRS 3receptors are probably the receptors more involved in this disease.(iii) Exposure to the degradation products of fetal/maternal bloodon maternal deciduas is a potentially dangerous phenomenon inpregnancy.
Abruptio placenta and TLRs 2-3-4
Ragusa Antonio;
2012-01-01
Abstract
Background and aims:We have assumed that decidual maternalexposure to degradation products of blood could activate theinnate immune system in the maternal/fetal interface, throughstimulation of decidual TLRs 2-3-4 and this can lead to placentaabrution. With the objective to evaluate this hypothesis, we havedesigned this prospective double blind study.Methods:Placentas from 12 pregnant patients, came to ouremergency room for suspicion detachment of the placenta, werecollected from the delivery unit of Niguarda Hospital in Milan,Italy (first group). Placentas from 16 normal term pregnanciesFree Communication Presentations64ª2008 The AuthorsªRCOG 2008 BJOG An International Journal of Obstetrics and Gynaecologywho had given birth just before or shortly after of the previouspatients served as physiological controls and were collected. Afteradequate preparation the anti-TLR2 antibody, the anti TLR3antibody and the anti TLR4 antibody have been tested onplacenta with Immunofluorescence technique.Results:This study showed a trend to decidual TLRs 3 activation,compared to the population of physiological control (P= 0.0179).Unlike decidual TLRs 2 and 4 are not activated (P= 0.9779 andP= 0.1671 respectively).Discussion:TLR3, unlike other TLRs, is triggered also from RNAas an endogenous product. It is possible that the TLRs 3 areactivated by the degradation products of blood, while TLR 2 and4 are not activated.Conclusion:From our study is not possible to understand whetherthe activation of TLRs 3 determines the detachment of theplacenta, or if it is the detachment of the placenta that, throughgreater contact between decidual tissue and degradation productsof blood (both maternal and fetal) determines activation of TLRs3. However, the study tells us three important messages for futureresearch: (i) The innate immune system plays an important rolein the genesis of the detachment of the placenta. (ii) The TLRS 3receptors are probably the receptors more involved in this disease.(iii) Exposure to the degradation products of fetal/maternal bloodon maternal deciduas is a potentially dangerous phenomenon inpregnancy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.