Variations in expression of copper/zinc superoxide dismutase in villous trophoblast of the human placenta with gestational age

Trophoblastic oxidative stress in relation to temporal and regional differences in maternal placental blood flow in normal and abnormal early pregnancies

Onset of the maternal-placental circulation was studied by Doppler ultrasonography in 65 pairs of age-matched normal and abnormal pregnancies. In normal pregnancies intervillous blood flow increased with gestational age, being detected in 9 of 25 cases at 8 to 9 weeks but in 18 of 20 at 12 to 13 weeks (P = 0.001). By contrast, in abnormal pregnancies flow was detected in nearly all cases (22 of 25) at 8 to 9 weeks (P < 0.001). In addition, regional differences were observed between the groups. Early flow was restricted to the peripheral regions of most normal placentas (P < 0.001), whereas in missed miscarriages it was most common in central regions or throughout the placenta (P < 0.05 and P < 0.001, respectively). Immunoreactivity for heat shock protein 70 and nitrotyrosine residues was greater in samples from peripheral than from central regions of normal placentas (P = 0.028 and P = 0.019, respectively), and from missed miscarriages compared to controls (P = 0.005 and P = 0.001, respectively). Our results indicate that oxidative damage to the trophoblast, induced by premature and widespread onset of the maternal placental circulation secondary to shallow trophoblast invasion, is a key factor in early pregnancy loss. High oxygen concentrations in the periphery of normal early placentas may similarly induce local regression of the villi, leading to formation of the chorion laeve.

In vitro ischemia-reperfusion injury in term human placenta as a model for oxidative stress in pathological pregnancies

Oxidative stress is a prominent feature of the placenta in many complications of pregnancy, such as preeclampsia. The cause is primarily unknown, although ischemia-reperfusion injury is one possible mechanism. Our aim was to test this hypothesis by examining the oxidative status of human placental tissues during periods of hypoxia and reoxygenation in vitro. Rapid generation of reactive oxygen species was detected using the fluorogenic probe, 2',7'-dichlorofluorescein diacetate, when hypoxic tissues were reoxygenated. The principal sites were the villous endothelium, and to a lesser extent the syncytiotrophoblast and stromal cells. Increased concentrations of heat shock protein 72, nitrotyrosine residues, and 4-hydroxy-2-nonenal were also observed in the villous endothelial and underlying smooth muscle cells, and in the syncytiotrophoblast. Furthermore, preloading placental tissues with the reactive oxygen species scavengers desferrioxamine and alpha-phenyl-N-tert-butylnitrone reduced levels of oxidative stress after reoxygenation. These changes are consistent with an ischemia-reperfusion injury, and mirror those seen in preeclampsia. Consequently, in vitro hypoxia/reoxygenation may represent a suitable model system for investigating the generation of placental oxidative stress in preeclampsia and other complications of pregnancy.

Maternal vascularisation of the human placenta: does the embryo develop in a hypoxic environment?

Compared to other mammals, implantation in the human establishes a precocious and intimate apposition between the maternal and fetal tissues. In the past it has been assumed that this relationship permits early onset of haemotrophic exchange, which in turn confers evolutionary advantage by supporting higher development. However, there is now strong evidence from a number of different disciplines to suggest that human pregnancy comprises two contrasting periods. During the first trimester there is little maternal bloodflow to the placenta, the oxygen tension within the feto-placental unit is low, and the uterine glands may provide much of the nutrient supply. At the start of the second trimester the maternal circulation within the intervillous space becomes fully established, the oxygen tension rises and haemotrophic nutrition becomes dominant. During the transition period there is a period of placental oxidative stress, and the response of the tissues to the changing oxygen concentration may play a pivotal role in determining the success or otherwise of the pregnancy.

Onset of maternal arterial blood flow and placental oxidative stress. A possible factor in human early pregnancy failure

The aim was to measure changes in the oxygen tension within the human placenta associated with onset of the maternal arterial circulation at the end of the first trimester of pregnancy, and the impact on placental tissues. Using a multiparameter probe we established that the oxygen tension rises steeply from <20 mmHg at 8 weeks of gestation to >50 mmHg at 12 weeks. This rise coincides with morphological changes in the uterine arteries that allow free flow of maternal blood into the placenta, and is associated with increases in the mRNA concentrations and activities of the antioxidant enzymes catalase, glutathione peroxidase, and manganese and copper/zinc superoxide dismutase within placental tissues. Between 8 to 9 weeks there is a sharp peak of expression of the inducible form of heat shock protein 70, formation of nitrotyrosine residues, and derangement of the mitochondrial cristae within the syncytiotrophoblast. We conclude that a burst of oxidative stress occurs in the normal placenta as the maternal circulation is established. We speculate that this may serve a physiological role in stimulating normal placental differentiation, but may also be a factor in the pathogenesis of pre-eclampsia and early pregnancy failure if antioxidant defenses are depleted.

Ontogenic profile of some antioxidants and lipid peroxidation in human placental and fetal tissues

Reactive oxygen species (ROS) pose a serious threat to maternal and fetal health during pregnancy. However, there is little information on the oxidative damage caused by ROS and its protection during prenatal life. The present study highlights the status of various antioxidants in human placental and fetal tissues at different phases of gestation. The activity profile of scavenging enzymes, superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase as well as the concentrations of non-enzymatic antioxidants, ascorbic acid, alpha-tocopherol, bilirubin and glutathione have been determined in human placental whole homogenate, placental brush border membrane and fetal liver over gestational periods ranging from 6 weeks of pregnancy till birth. The ontogenic profile of lipid peroxidation, a marker of oxidative damage has also been investigated in the feto-placental system. Catalase, superoxide dismutase and glutathione reductase activities increased significantly, but glutathione peroxidase activity remained almost the same throughout development. Except alpha-tocopherol and bilirubin, the concentrations of other non-enzymic scavengers followed a significant increasing trend with advancement of pregnancy. Results indicate that there is gradual suppression of lipoperoxide formation with the progress of gestation to protect the fetus against oxygen toxicity.

Modulation of copper/zinc superoxide dismutase expression and activity with in vitro differentiation of human villous cytotrophoblasts

Due to the role of oxygen free radicals in trophoblast cell differentiation, we used the in vitro model of villous cytotrophoblast differentiation into the syncytiotrophoblast to investigate the modulation of the key antioxidant enzyme copper/zinc superoxide dismutase (SOD-1) in the human trophoblast during pregnancy. Cytotrophoblast cells were isolated from first-trimester and term placentae. SOD-1 mRNA levels were determined using real-time quantitative polymerase chain reaction, protein levels were determined by immunoblotting with a specific monoclonal antibody, and oxidoreductase activity was measured during syncytiotrophoblast formation in vitro. Interestingly, SOD-1 protein levels fell significantly (P< 0.001) during syncytiotrophoblast formation but no corresponding change in enzyme activity was observed. This apparent discrepancy may be related to different amounts of SOD-1 co-factor in the two cell types. Indeed the level of copper was significantly higher (P< 0.05) in syncytiotrophoblast as compared with cytotrophoblast. SOD-1 mRNA levels remained stable during cytotrophoblast differentiation. SOD-1 expression and activity were similar in cytotrophoblast cells isolated from first-trimester and term placentae, and in the differentiated syncytiotrophoblast in vitro. These results underline the need to determine SOD-1 protein expression and activity simultaneously in order to gain a better knowledge of its role in human trophoblast cell differentiation.

Maternal arterial connections to the placental intervillous space during the first trimester of human pregnancy: the Boyd collection revisited

OBJECTIVE

We sought to determine morphologically when the maternal uterine circulation to the human placenta is established.

STUDY DESIGN

We performed a histologic review of 12 early-pregnancy hysterectomy specimens contained within the Boyd Collection, ranging from 43 to 130 days' gestation.

RESULTS

Before the eighth week of pregnancy, maternal arterial connections with the intervillous space are restricted to tortuous networks of intercellular spaces. Only after this period can direct channels be observed. Initially, these are of small caliber, but they become sizable and clearly delineated after 11 to 12 weeks.

CONCLUSION

The maternal circulation to the placenta must be extremely sluggish before the eighth week of pregnancy but will be gradually established over the next few weeks. It is unlikely to be substantial until at least 12 weeks. The implication is that development of the human fetoplacental unit during most of the first trimester takes place in a low-oxygen environment.

Antioxidant status and lipid peroxidation in human feto-placental unit

The human feto-placental unit being in the environment of the materno-fetal circulation is very much susceptible to the danger of reactive oxygen species-induced oxidative damage. The present study reports the status of various antioxidants in the feto-placental system at birth. The activities of superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase as well as concentrations of non-enzymic antioxidants viz, ascorbic acid, alpha-tocopherol, bilirubin and glutathione have been determined in term placental brush border membrane (BBM) and umbilical cord (UC) blood. The extent of lipid peroxidation in developing and term BBM and UC blood has been studied by estimation of malondialdehyde and conjugated dienes, both being the end products of lipid peroxidation. The results indicate the presence of a protective mechanism against oxygen toxicity in the feto-placental system at the time of parturition.

The application of individualised fetal growth curves

Individually adjusted or 'customised' growth charts aim to optimise the assessment of fetal growth by taking individual variation into account, and by projecting an optimal curve which delineates the potential weight gain in each pregnancy. This results in an increased detection rate of true growth restriction and a reduction in false positive diagnoses for IUGR. An adjustable standard can apply across geographical boundaries, as individual variation exceeds that between different maternity populations.

Free amino acid distribution inside the first trimester human gestational sac

The trophoblast functions of nutrient transport and protein synthesis generate high concentrations of amino acids in the placenta and in fetal blood during the second half of pregnancy, but little is known about these metabolic processes in embryonic and early fetal periods. The aim of this study is to compare the distribution of amino acids inside the first trimester gestational sac. Free amino acid concentrations were measured in homogenates of placental villi, in samples of coelomic and amniotic fluid, and in the maternal serum from 17 normal pregnancies between 7 and 11 weeks of gestation. Significant positive relationships between maternal serum and placental tissue were found for 10 amino acids, indicating that active amino acid transport and accumulation by the human syncytiotrophoblast occurs as early as 7 weeks of gestation. The transplacental flux of most amino acid transport from maternal blood to the exocoelomic cavity was against a concentration gradient. The highest placental amino acid concentrations were found for taurine, glutamic acid, glycine and alanine. The amniotic fluid contained lower mean concentration of all amino acids than coelomic fluid and maternal serum. The concentration distribution of individual amino acids in coelomic and amniotic fluid were related indicating a passive transfer through the amniotic membrane. A coelomic-maternal gradient was observed in 19 out of 24 amino acids measured and positive correlations were found between maternal serum and coelomic fluid for concentrations of alpha-aminobutyric acid, tyrosine and histidine, suggesting that these amino acids are only partially retained and/or transferred more rapidly by the early placenta.

Susceptibility of human placental syncytiotrophoblastic mitochondria to oxygen-mediated damage in relation to gestational age

When maintaining first trimester placental villi in organ culture under conventional normoxic conditions, we have observed widespread degeneration of the syncytiotrophoblast within 24 h despite excellent viability for the cytotrophoblastic and stromal cell types. Here we identify loss of mitochondrial activity as an early event in this process. In the light of proposals that the early part of gestation occurs in a low oxygen environment and also reported associations between mitochondrial disruption and oxidative stress, we cultured first trimester villi under low oxygen conditions (2.5%). Mitochondrial superoxide dismutase (MnSOD) localization and activity at different gestational ages were also determined. It was found that syncytiotrophoblastic and mitochondrial morphology improved, and mitochondrial activity was retained for 6 h and more if 8- to 10-week-old tissue was placed into a low oxygen environment immediately after removal from the uterus. The effect of oxygen concentration was less marked when using tissue of 14 weeks or more gestational age, which showed good survival and retention of mitochondrial activity under both low and ambient oxygen conditions. This correlated with our finding that placental MnSOD activity increased significantly between 8 and 14 weeks of gestation. Immunohistochemistry demonstrated that at 11 weeks; MnSOD was localized predominantly within the cytotrophoblast cells, whereas by 16 weeks it was found in the syncytiotrophoblast also. These results indicate an acute sensitivity of first trimester placenta syncytiotrophoblast to oxygen-mediated damage.

Changes in concentration, localization and activity of catalase within the human placenta during early gestation

Using villous tissue from accurately dated gestational age placentae, this study identified significant changes in the protein concentration, enzyme activity and localization of catalase, an enzyme responsible for the intracellular metabolism of hydrogen peroxide, during the first and early second trimester of pregnancy. Enzyme activity was found to increase approximately threefold between weeks 6 and 17, with the greatest increase between 12 and 17 weeks. Immunostaining of tissue sections was supportive of these findings, demonstrating a progressively stronger signal between weeks 6 and 17. Immunostaining also demonstrated that the main cell types expressing catalase were the cytotrophoblast cells as well as a subset of the stromal cells. Between 13-17 weeks gestation, however, it was possible to detect catalase within the syncytiotrophoblast also, although with a much reduced intensity of staining. At the ultrastructural level, immunogold labelling of catalase clearly showed that staining was predominately compartmentalized within peroxisomes, although non-peroxisomal staining was also seen. Immunoreactivity also demonstrated, via morphological identification, that the stromal cells containing detectable levels of catalase were placental macrophages (Hofbauer cells). These results are in agreement with the proposal that the placenta exists in a physiologically low oxygen environment during the early part of gestation. In this environment oxidative activity of the sort resulting in the generation of hydrogen peroxide would presumably be suppressed, thereby limiting the requirement for catalase until oxygen tension begins to rise.

The Structure of the Human Placenta: Implications for Initiating and Defending Against Virus Infections

The architecture of the human placenta permits an extensive and intimate association between the maternal and fetal circulations. The fetal component consists of the elaborately branched villous tree, and this is bathed directly by maternal blood circulating within the intervillous space. Whilst this arrangement may favour metabolic exchange, it poses considerable risks for the vertical transmission of pathogens. Some features of placental structure can be considered potential impediments to transmission, such as the syncytial nature of the outer villous covering, the syncytiotrophoblast, and the ability of this tissue to secrete both nitric oxide and interferons. Other features may facilitate vertical transmission, including the lack of expression of MHC Class 1 antigens by the syncytiotrophoblast, and its vesicular and immunoglobulin transport pathways. More importantly, it is known that physical defects occur in the trophoblast layers at all stages in gestation. Whilst repair processes have been identified it must be assumed that pathogens or infected maternal white cells have access to the trophoblastic basement membrane, albeit transiently. The universal nature of these defects suggests that the trophoblast cannot be of paramount importance in the prevention of transmission. Rather, the defence mechanisms must lie either at the level of the basement membrane or within the villous core. There they may be represented by the resident macrophage population or the capillary endothelial cells and their junctional complexes. Consequently, the placenta should be viewed as an active rather than a passive barrier. Copyright 1997 by John Wiley & Sons, Ltd.