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Scott AK, Fodera DM, Yang P, Arter A, Hines AM, Kolluru SS, Zambuto SG, Myers KM, Kamilov US, Odibo AO, Oyen ML. Bioengineering approaches for patient-specific analysis of placenta structure and function. Placenta 2024:S0143-4004(24)00615-5. [PMID: 39153938 DOI: 10.1016/j.placenta.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/30/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024]
Abstract
The leading cause of perinatal mortality is fetal growth restriction (FGR), defined as in utero fetal growth below the 10th percentile. Insufficient exchange of oxygen and nutrients at the maternal-fetal interface is associated with FGR. This transport occurs through the vasculature of the placenta, particularly in the terminal villi, where the vascular membranes have a large surface area and are the thinnest. Altered structure of the placenta villi is thought to contribute to decreased oxygen exchange efficiency, however, understanding how the three-dimensional microstructure and properties decrease this efficiency remains a challenge. Here, a novel, multiscale workflow is presented to quantify patient-specific biophysical properties, 3D structural features, and blood flow of the villous tissue. Namely, nanoindentation, optical coherence tomography, and ultrasound imaging were employed to measure the time-dependent material properties of placenta tissue, the 3D structure of villous tissue, and blood flow through the villi to characterize the microvasculature of the placenta at increasing length scales. Quantifying the biophysical properties, the 3D architecture, and blood flow in the villous tissue can be used to infer changes in maternal-fetal oxygen transport at the villous membrane. Overall, this multiscale understanding will advance knowledge of how microvascular changes in the placenta ultimately lead to FGR, opening opportunities for diagnosis and intervention.
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Affiliation(s)
- Adrienne K Scott
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis MO, USA; Center for Women's Health Engineering, Washington University in St. Louis, St. Louis MO, USA; Center for Regenerative Medicine, Washington University in St. Louis, St. Louis MO, USA
| | - Daniella M Fodera
- Department of Biomedical Engineering, Columbia University, New York NY, USA
| | - Patrick Yang
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis MO, USA; Center for Women's Health Engineering, Washington University in St. Louis, St. Louis MO, USA
| | - Abigail Arter
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis MO, USA
| | - Amelia M Hines
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis MO, USA; Center for Women's Health Engineering, Washington University in St. Louis, St. Louis MO, USA
| | - Samyuktha S Kolluru
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis MO, USA; Center for Women's Health Engineering, Washington University in St. Louis, St. Louis MO, USA
| | - Samantha G Zambuto
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis MO, USA; Center for Women's Health Engineering, Washington University in St. Louis, St. Louis MO, USA; Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis MO, USA
| | - Kristin M Myers
- Department of Mechanical Engineering, Columbia University, New York NY, USA
| | - Ulugbek S Kamilov
- Department of Computer Science & Engineering, Washington University in St. Louis, St. Louis MO, USA; Department of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis MO, USA
| | - Anthony O Odibo
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis MO, USA
| | - Michelle L Oyen
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis MO, USA; Center for Women's Health Engineering, Washington University in St. Louis, St. Louis MO, USA; Center for Regenerative Medicine, Washington University in St. Louis, St. Louis MO, USA; Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis MO, USA.
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Hermans S, Pilon J, Eschweiler D, Stegmaier J, Severens–Rijvers CAH, Al-Nasiry S, van Zandvoort M, Kapsokalyvas D. Definition and Quantification of Three-Dimensional Imaging Targets to Phenotype Pre-Eclampsia Subtypes: An Exploratory Study. Int J Mol Sci 2023; 24:ijms24043240. [PMID: 36834652 PMCID: PMC9959375 DOI: 10.3390/ijms24043240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/10/2023] Open
Abstract
Pre-eclampsia is a severe placenta-related complication of pregnancy with limited early diagnostic and therapeutic options. Aetiological knowledge is controversial, and there is no universal consensus on what constitutes the early and late phenotypes of pre-eclampsia. Phenotyping of native placental three-dimensional (3D) morphology offers a novel approach to improve our understanding of the structural placental abnormalities in pre-eclampsia. Healthy and pre-eclamptic placental tissues were imaged with multiphoton microscopy (MPM). Imaging based on inherent signal (collagen, and cytoplasm) and fluorescent staining (nuclei, and blood vessels) enabled the visualization of placental villous tissue with subcellular resolution. Images were analysed with a combination of open source (FIJI, VMTK, Stardist, MATLAB, DBSCAN), and commercially (MATLAB) available software. Trophoblast organization, 3D-villous tree structure, syncytial knots, fibrosis, and 3D-vascular networks were identified as quantifiable imaging targets. Preliminary data indicate increased syncytial knot density with characteristic elongated shape, higher occurrence of paddle-like villous sprouts, abnormal villous volume-to-surface ratio, and decreased vascular density in pre-eclampsia compared to control placentas. The preliminary data presented indicate the potential of quantifying 3D microscopic images for identifying different morphological features and phenotyping pre-eclampsia in placental villous tissue.
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Affiliation(s)
- Sammy Hermans
- Department of Genetics and Cell Biology, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Jacob Pilon
- Department of Genetics and Cell Biology, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Dennis Eschweiler
- Institute of Imaging and Computer Vision, RWTH Aachen University, 52074 Aachen, Germany
| | - Johannes Stegmaier
- Institute of Imaging and Computer Vision, RWTH Aachen University, 52074 Aachen, Germany
| | | | - Salwan Al-Nasiry
- Obstetrics and Gynaecology, GROW, Maastricht University Medical Centre (MUMC), 6229 HX Maastricht, The Netherlands
| | - Marc van Zandvoort
- Department of Genetics and Cell Biology, GROW, CARIM, MHeNS, Maastricht University, 6200 MD Maastricht, The Netherlands
- Institute for Molecular Cardiovascular Research IMCAR, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Dimitrios Kapsokalyvas
- Department of Genetics and Cell Biology, Maastricht University, 6200 MD Maastricht, The Netherlands
- Interdisciplinary Centre for Clinical Research IZKF, University Hospital RWTH Aachen, 52074 Aachen, Germany
- Correspondence:
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Lewis RM, Pearson-Farr JE. Multiscale three-dimensional imaging of the placenta. Placenta 2020; 102:55-60. [DOI: 10.1016/j.placenta.2020.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 01/18/2023]
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Advances in imaging feto-placental vasculature: new tools to elucidate the early life origins of health and disease. J Dev Orig Health Dis 2020; 12:168-178. [PMID: 32746961 DOI: 10.1017/s2040174420000720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Optimal placental function is critical for fetal development, and therefore a crucial consideration for understanding the developmental origins of health and disease (DOHaD). The structure of the fetal side of the placental vasculature is an important determinant of fetal growth and cardiovascular development. There are several imaging modalities for assessing feto-placental structure including stereology, electron microscopy, confocal microscopy, micro-computed tomography, light-sheet microscopy, ultrasonography and magnetic resonance imaging. In this review, we present current methodologies for imaging feto-placental vasculature morphology ex vivo and in vivo in human and experimental models, their advantages and limitations and how these provide insight into placental function and fetal outcomes. These imaging approaches add important perspective to our understanding of placental biology and have potential to be new tools to elucidate a deeper understanding of DOHaD.
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Sargent J, Roberts V, D’Souza K, Wright A, Gaffney J, Frias A. Micro-anatomic alterations of the placenta in a non-human primate model of gestational protein-restriction. PLoS One 2020; 15:e0235840. [PMID: 32702025 PMCID: PMC7377450 DOI: 10.1371/journal.pone.0235840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives Maternal protein malnutrition is associated with impaired fetal growth, and lifetime consequences for the offspring. Our group has previously developed a model of protein-restriction in the non-human primate, which was associated with fetal growth restriction, stillbirth, decreased placental perfusion, and evidence of fetal hypoxia, suggesting perturbed vascular development. Our objective was to histologically characterize the micro-anatomic alterations associated with adverse pregnancy outcomes taking an approach that permits investigation of the 3D vascular structure and surrounding histology without the requirement for 3D vascular casting or relying on 2D stereology which both have methodological limitations. Methods Rhesus macaques were assigned in the pre-gestational period to a control diet that contained 26% protein, or study diet containing 13% protein (50% PR diet). Placental tissue was collected at delivery and processed using a clarification, immunohistochemistry, and confocal microscopy protocol published previously by our group. Three dimensional reconstructions and quantitative assessment of the vascular micro-anatomy was performed using analysis software (Imaris®) and statistical analysis accounted for maternal and fetal confounders. Results In unadjusted analysis, when comparing those pregnancies on a 50% PR diet (n = 4) with those on a control diet (n = 4), protein-restriction diet was associated with decreased maternal pre-pregnancy weight (difference of -1.975kg, 95% CI -3.267 to -0.6826). When controlling for maternal pre-pregnancy weight, fetal sex, and latency from tissue collection to imaging, a gestational protein-restriction diet was associated with decreases in total vascular length, total vascular surface area, total vascular volume, and vascular density. Conclusion In this pilot study, a gestational protein-restriction diet altered the placental micro-vasculature with decreased vascular caliber and density, which may be related to the observed adverse pregnancy outcomes and perturbed placental perfusion previously demonstrated in this model.
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Affiliation(s)
- James Sargent
- The University of Texas Health Science at Houston, Houston, Texas, United States of America
- * E-mail:
| | - Victoria Roberts
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Karen D’Souza
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Adam Wright
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Jessica Gaffney
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
| | - Antonio Frias
- Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center, Beaverton, Oregon, United States of America
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, United States of America
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Marr N, Hopkinson M, Hibbert AP, Pitsillides AA, Thorpe CT. Bimodal Whole-Mount Imaging of Tendon Using Confocal Microscopy and X-ray Micro-Computed Tomography. Biol Proced Online 2020; 22:13. [PMID: 32624710 PMCID: PMC7329428 DOI: 10.1186/s12575-020-00126-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/21/2020] [Indexed: 12/25/2022] Open
Abstract
Background Three-dimensional imaging modalities for optically dense connective tissues such as tendons are limited and typically have a single imaging methodological endpoint. Here, we have developed a bimodal procedure utilising fluorescence-based confocal microscopy and x-ray micro-computed tomography for the imaging of adult tendons to visualise and analyse extracellular sub-structure and cellular composition in small and large animal species. Results Using fluorescent immunolabelling and optical clearing, we visualised the expression of the novel cross-species marker of tendon basement membrane, laminin-α4 in 3D throughout whole rat Achilles tendons and equine superficial digital flexor tendon 5 mm segments. This revealed a complex network of laminin-α4 within the tendon core that predominantly localises to the interfascicular matrix compartment. Furthermore, we implemented a chemical drying process capable of creating contrast densities enabling visualisation and quantification of both fascicular and interfascicular matrix volume and thickness by x-ray micro-computed tomography. We also demonstrated that both modalities can be combined using reverse clarification of fluorescently labelled tissues prior to chemical drying to enable bimodal imaging of a single sample. Conclusions Whole-mount imaging of tendon allowed us to identify the presence of an extensive network of laminin-α4 within tendon, the complexity of which cannot be appreciated using traditional 2D imaging techniques. Creating contrast for x-ray micro-computed tomography imaging of tendon using chemical drying is not only simple and rapid, but also markedly improves on previously published methods. Combining these methods provides the ability to gain spatio-temporal information and quantify tendon substructures to elucidate the relationship between morphology and function.
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Affiliation(s)
- Neil Marr
- Comparative Biomedical Sciences, Royal Veterinary College, Royal College Street, London, UK
| | - Mark Hopkinson
- Comparative Biomedical Sciences, Royal Veterinary College, Royal College Street, London, UK
| | - Andrew P Hibbert
- Comparative Biomedical Sciences, Royal Veterinary College, Royal College Street, London, UK
| | - Andrew A Pitsillides
- Comparative Biomedical Sciences, Royal Veterinary College, Royal College Street, London, UK
| | - Chavaunne T Thorpe
- Comparative Biomedical Sciences, Royal Veterinary College, Royal College Street, London, UK
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