Serum concentration of vascular endothelial growth factor and depth of trophoblastic invasion in ampullary ectopic pregnancy

Interaction networks between the Fallopian tubes and the embryo in human tubal pregnancy: Current knowledge and perspectives

AIM

More than 90% of ectopic pregnancies occur in the Fallopian tubes. As the pathogenesis of tubal pregnancy remains largely unclear, the development of strategies to prevent and treat tubal pregnancy still represents a major clinical challenge. This review thoroughly summarizes the current data, aiming to determine the genes and signaling pathways that are involved in the pathophysiology of human tubal pregnancy.

METHODS

An electronic search from databases of PubMed, Google Scholar, and Chinese databases was carried out using key words pertaining to the pathogenesis of tubal pregnancy from the perspectives of both the Fallopian tubes and the embryo. A review of the literatures including review articles, experimental, and observational studies and case reports published between 1999 and 2021 was conducted.

RESULTS

Tubal pregnancy results from the interaction networks between the Fallopian tube and the embryo rather than from simple tubal abnormality. Furthermore, the embryo-maternal communication is supposed to start from the preimplantation period to the implantation period.

CONCLUSION

A greater understanding of the interaction networks between the Fallopian tubes and the embryo is of great significance for the prevention and medical treatment of tubal pregnancy.

Expression of matrix metalloproteinases and their inhibitors at the implantation site in ampullary ectopic pregnancies

OBJECTIVE

This study investigated the qualitative and semi-quantitative expression of metalloproteinases (MMP) and their tissue inhibitors (TIMP) in trophoblastic tissue during ampullary ectopic pregnancies and correlated that expression with the degree of tubal invasion.

STUDY DESIGN

It is a prospective study that included 34 patients diagnosed with ampullary tubal pregnancy who underwent salpingectomy. A histological evaluation of the depth of trophoblastic invasion in the tubes obtained was performed. Subsequently, the expression of the MMP-2, MMP-9, MMP-14, TIMP-1, TIMP-2 and TIMP-3 markers was qualitatively and semi-quantitatively evaluated by indirect immunohistochemistry. In addition, the degree of trophoblastic invasion was correlated with the expression of each marker and with the metalloproteinase/inhibitor ratios.

RESULTS

MMP-2 (11.2 %; 3.6-17.9) was the marker with greater expression at the implantation site, both in the qualitative and semi-quantitative assessment, while MMP-9 (2.23 %; 0.2-5.4) and TIMP-3 (2.53 %; 0.1-15.3) were only weakly expressed.

CONCLUSION

There was wide variation in expression among the markers and metalloproteinase/inhibitor ratios studied compared to the degrees of invasion.