Increased placental expression of Placental Protein 5 (PP5) / Tissue Factor Pathway Inhibitor-2 (TFPI-2) in women with preeclampsia and HELLP syndrome: Relevance to impaired trophoblast invasion?

• Published in: Placenta (Eastbourne) Vol. 76; pp. 30 - 39
• Main Authors: Karaszi, Katalin, Szabo, Szilvia, Juhasz, Kata, Kiraly, Peter, Kocsis-Deak, Barbara, Hargitai, Beata, Krenacs, Tibor, Hupuczi, Petronella, Erez, Offer, Papp, Zoltan, Kovalszky, Ilona, Than, Nandor Gabor
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 15.01.2019
• Subjects: Adult; Case-Control Studies; Coagulation; Female; Glycoproteins - metabolism; HELLP Syndrome - metabolism; HELLP Syndrome - pathology; Humans; Invasion; Placenta; Placenta - metabolism; Placenta - pathology; Placentation; Pre-Eclampsia - metabolism; Pre-Eclampsia - pathology; Pregnancy; Trophoblast; Pregnancy; Trophoblast; Placenta; Invasion; Coagulation
• ISSN: 0143-4004; 1532-3102
• DOI: 10.1016/j.placenta.2019.01.011

Placental Protein 5 (PP5)/Tissue Factor Pathway Inhibitor-2 (TFPI-2) is an extracellular matrix-associated protein mainly expressed by the syncytiotrophoblast that may regulate trophoblast invasion. Our aim was to study placental PP5/TFPI-2 expression and its relation to placental pathology in various forms of preeclampsia and HELLP syndrome. Placental and maternal blood specimens were collected at the time of delivery from the same women in the following groups: 1) early controls; 2) early preeclampsia; 3) early preeclampsia with HELLP syndrome; 4) late controls; and 5) late preeclampsia. After histopathological examination, placental specimens were immunostained with polyclonal anti-PP5/TFPI-2 antibody on Western blot and tissue microarray immunohistochemistry. Placental PP5/TFPI-2 immunoscores were assessed manually and with a semi-automated method. Maternal sera were immunoassayed for PP5/TFPI-2. PP5/TFPI-2 was localized to the cytoplasm of syncytiotrophoblast. Manual and semi-automated PP5/TFPI-2 immunoscores were higher in early preeclampsia with or without HELLP syndrome but not in late preeclampsia than in respective controls. In patients with preeclampsia, the correlation of placental PP5/TFPI-2 expression with maternal vascular malperfusion score of the placenta was positive while it was negative with birthweight and placental weight. Maternal serum PP5/TFPI-2 concentration was higher in early preeclampsia and it tended to be higher in early preeclampsia with HELLP syndrome than in early controls. Our findings suggest that an increased placental PP5/TFPI-2 expression may be associated with abnormal placentation in early preeclampsia, with or without HELLP syndrome. •PP5/TFPI-2 is predominantly produced in large amounts by the placenta.•PP5/TFPI-2 is mainly expressed by the syncytiotrophoblast.•Placental PP5/TFPI-2 expression is increased in early- but not late preeclampsia.•Maternal serum PP5/TFPI-2 is increased in early- but not late preeclampsia.•Placental PP5/TFPI-2 correlates with maternal vascular malperfusion of the placenta.