CD56 expression of intravascular trophoblasts defines a class of vasculopathy in preeclampsia and other pregnancy complications

Abstract

AbstractWe have discovered the expression of CD56 on the intravascular trophoblasts in the maternal spiral artery at implantation sites, and we have also found the similar phenotypic switch of intravascular trophoblasts in the decidual vasculopathy in preeclampsia. Currently we have examined 124 placentas from the patients with preeclampsia and 84 placentas from patients with other pregnancy associated complications without preeclampsia. CD56 expression on the intravascular trophoblasts can be seen in classic decidual vasculopathy such as fibrinoid medial necrosis and acute atherosis. In addition, partial involvement of the decidual vessels with classic vasculopathy can also be identified by CD56 expression. The cellular components of the classic vasculopathy in preeclampsia showed immunoreactivity to cytokeratin and CD68, in addition to CD56 expression, indicating the fetal trophoblastic cell origin. The classic decidual vasculopathy including acute atherosis and fibrinoid medial necrosis can be unified and designated as CD56-related vasculopathy. The CD56 related vasculopathy is associated not only to preeclampsia but also to other pregnancy related complications, such as gestational diabetes, placental infarcts, intervillous thrombosis and other fetal distress syndromes. Our study defined a spectrum of decidual vasculopathy spanning from the classic preeclampsia to other complications important to pregnancy that can be highlighted by CD56 expression, pointing to different direction of pathogenesis of preeclampsia and other pregnancy associated complications.