The aim of this study is to determine the alteration of extracellular matrix (ECM), namely fibronectin and collagen type IV, in the aetiology of hypertensive disorders of pregnancy. Gestational hypertension and preeclampsia account for 5-7% of the maternal mortality and morbidity worldwide. Gestational hypertension and preeclampsia is characterised by blood pressure of 140/90 mmHg or greater after the 20th week of gestation. The aetiology of gestational hypertension and preeclampsia is closely related to the disorder of placenta implantation. It is thought that shallow trophoblast invasion into maternal decidua causes malfunction of the utero-placental arteries, thus leading to both the diseases. The exact cause of shallow trophoblast invasion remains controversial. Placenta implantation involves activation and migration of trophoblast into the decidua and myometrium. These processes are dependent on extracellular matrix, where activation of appropriate adhesion molecules and integrins are essential for appropriate trophoblast activity. In this study, collagen type IV and fibronectin were investigated in a total of 30 placentas by immunohistochemistry and H&E stains. Observation on the staining intensity of the antibodies were done in both villous (foetal) and decidual (maternal) areas. Statistical analysis was performed using Mann-Whitney test. The analysis showed a significant increase of number of villi in gestational hypertensive and preeclamptic placentas compared to normotensive placentas. Staining intensity of collagen type IV and fibronectin suggested an alteration of level of these components in gestational hypertension and preeclampsia group compared to normotensive group and this alteration may play a role in the aetiology of the two hypertensive diseases.
J.P. Judson, S. Chakravarthi, L.S. Han, S. Rahman and S. Nalliah, 2011. The Role of Extracellular Matrix in the Aetiology of Gestational Hypertension and Preeclampsia: A Preliminary Study. Trends in Molecular Sciences, 3: 14-24.