IMMUNOHISTOCHEMICAL EXPRESSION E-CADHERIN IN THE BASEMENT MEMBRANE OF CYTOTROPHOBLAST, SYNCYTIOTROPHOBLAST AND BLOOD VESSELS OF PLACENTA OF PRE-ECLAMPSIA

Abstract

BACKGROUND: Pre-eclampsia, a severe pregnancy condition which is evident by increased blood pressure and proteinuria after 20 weeks. Affecting 2-5% of all the pregnancies globally, it carries significant risks for both mother and baby.1 During pregnancy in the initial months there is a temporary decrease in E-cadherin expression within trophoblastic cells as they invade placenta, nevertheless the function of E-cadherin in regulation of placental vascularity is not fully understood. Hence this study aims to analyse the intensity and distribution of E-cadherin staining within the trophoblastic villi in healthy and pre-eclampsia placenta patients. AIMS & OBJECTIVES: 1. To determine the Immunohistochemistry (IHC) expression of E-cadherin in the placenta of healthy normal pregnancy and the placenta of pre-eclampsia. 2. To study the correlation of intensity of expression of E-cadherin and the severity of pre-eclampsia. MATERIALS & METHODS: This study was performed in Department of Pathology in association with Department of Obstetrics & Gynaecology, Sri Devaraj Urs Medical College attached to RLJH and Research Center, Tamaka, Kolar during the period of September 2022 to December 2023. The study included a total of 160 placenta cases that included 80 pre-eclampsia placentas and 80 normal healthy controls. IHC was performed using antibodies against E-cadherin and expression of E-cadherin was analysed and interpreted. E-cadherin expression was compared among the cases and the controls and was also correlated with clinicopathological parameters. Statistical xx analysis was performed using Chi-square test and mean along with standard deviation was also calculated. A p value of <0.05 was considered significant. RESULTS: The average median age of cases and controls was 26 years. Not only the age of females but also gestational age of the pregnant women along with gross weight of placenta, weight of baby, apgar score of the baby all these clinicopathological parameters were correlated among the pre-eclampsia cases and the healthy pregnant controls. The gross and microscopic findings that is necrosis, calcification, and thrombosis when compared among the preeclampsia cases and the healthy controls, these findings were more evident in the preeclampsia placentas compared to normal healthy controls and were statistically significant. The immunohistochemical expression of e-cadherin was measured in both healthy controls and pre-eclampsia cases and it showed high (grade 3) and continuity of expression e-cadherin in majority of the normal healthy placental villi and there was predominantly varied expression (grade 0,1,2&3) along with discontinuity in the staining of the placental villi in pre-eclamptic placentas and these findings were statistically significant. CONCLUSION: This study indicates that the reduced intensity and discontinuity of E-cadherin staining in preeclampsia cases point to a defect in placental barrier function. This defect likely contributes to the development of pre-eclampsia and associated pregnancy complications.