Morphology morphometry histomorphometry and immunohistochemistry expression of matrix metalloproteinase 2 and 9 from human umbilical cord in normal and hypertensive pregnancies of different severity

Abstract

Hypertensive disorders of pregnancy (HDP) are the most significant newlinemedical problems during pregnancy, complicating approximately 10% of newlinewomen around the world. It is the major cause of maternal and fetal mortality newlineand morbidity and carries long term risk of developing cardiovascular newlinediseases, hypertension, diabetes mellitus, cancer and several other diseases newlinefor both mother and fetus. As a fetal organ, the placenta and umbilical cord newlinewere studied extensively by anatomists, gynaecologists, embryologists and newlinepathologists and have reported the altered function in HDP. Previous studies newlinesuggested that, inadequate trophoblastic invasion of the maternal spiral newlinearteries lead to poorly perfused placenta, which promotes the secretion of newlinevasoactive factors which induce endothelial dysfunction central to the newlinepathogenesis of HDP. But the exact underlying pathogenesis of HDP is not newlineknown. newlineMatrix metalloproteinases (MMPs) are zinc dependent endopeptidases newlinewhich serves as key mediators of developmental processes such as cell newlinemigration, proliferation, apoptosis and tissue morphogenesis and also newlineinvolved in angiogenesis, endothelial cell invasion. Two gelatinases, namely newlineMMP-2 and MMP-9 are frequently implicated in trophoblastic invasion, newlineremodelling of spiral arteries, endothelial dysfunction. Prevailing evidence newlinesuggest that dysregulation of these proteins are thought to contribute to HDP. newlineThough few studies have been reported in the literature about the role of newlineMMP-2 and MMP-9 in the pathophysiology of HDP in the blood samples, newlineumbilical cord tissue level changes are not reported. Since there is a literature newlinegap on the role of MMP-2 and MMP-9 in umbilical cord tissue in relation with newlinedisease severity, the present study was undertaken. The result of the present study shows that hypertensive disorders of newlinepregnancy are associated with significant structural changes in both placenta newlineand umbilical cord. These structural alterations adversely affect the maternal newlineand fetal mortality and morbidity.