Significance of Complement Split Product C4d Deposition in Paraffin-Embedded Placenta of Systemic Lupus Erythematosus (SLE) and Pregnancy Induced Hypertension (PIH)
Sachiko Minamiguchi, Yoshiki Mikami, Yoshiki Iemura, Eiji Kondoh, Keiji Tatsumi, Ikuo Konishi, Hironori Haga. Kyoto University Hospital, Kyoto, Japan
Background: SLE and PIH are both related to premature labor and intrauterine growth retardation (IUGR) with similar histological findings of the placentas. The mechanism of placental injury of these different disorders, however, is still unclear. The purpose of this study was to investigate the utility of C4d immunostaining in placentas of SLE and PIH.
Design: Immunostaining of C4d was performed on paraffin-embedded tissue sections of placentas from 21 patients with SLE including 2 curettage cases because of uncontrollable clinical conditions, 21 with PIH, and 20 control cases. We used H-score for the evaluation of C4d immunoreactivity: The score was obtained by the formula: 3 x percentage of strongly staining trophoblasts plus 2 x percentage of moderately staining trophoblasts plus percentage of weakly staining trophoblasts, giving a range of 0 to 300. Clinical data were compared to H-score in both SLE and PIH.
Results: Immunoreactivity of C4d was significantly greater in villous trophoblastic membranes in SLE and PIH cases compared to control cases (P<0.05). Twelve (57%) of SLE including 2 curettage cases and 7 (33%) of PIH showed intermediate to strong-reactivity of C4d, with an H-score ranging from 14–270 and 15–105, respectively. All H-scores of control cases were less than 4. Placentas with intermediate to strong reactivity of C4d showed significantly low-placental weights (SLE, P<0.01; PIH, P<0.05), low-birth weights (SLE, P<0.01; PIH, P<0.05), and preterm birth in SLE (P<0.05) compared to low H-score (0-3) cases for each disorder.
Conclusions: The degree of C4d immunoreactivity was associated with low birth and placental weight in both PIH and SLE, and with preterm birth in SLE. These findings suggest that complement cascade is related to placental abnormality of both PIH and SLE. The evaluation of C4d in paraffin-embedded placenta, including abortion and curettage specimens, may be important information for subsequent pregnancies in these patients.
Category: Gynecologic & Obstetrics
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 163, Wednesday Morning