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Cordier AG, Bouvier AS, Vibert F, Martinovic J, Couturier-Tarrade A, Lai-Kuen R, Curis E, Fournier T, Benachi A, Peoc'H K, Gil S. Preserved efficiency of sickle cell disease placentas despite altered morphology and function. Placenta 2020; 100:81-88. [PMID: 32871493 DOI: 10.1016/j.placenta.2020.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Pregnant women with sickle cell disease (SCD) are at high risk for sickle cell-related complications, obstetrical complications, and perinatal morbidity. Chronic inflammation and the proangiogenic environment associated with SCD have been associated with endothelial damage. It is unknown whether SCD complications could be associated with placental dysfunction or abnormal placental morphology. Moreover, circulating angiogenic factors in pregnant women with SCD are unexplored. METHODS Clinical records, placental and blood samples were collected at term delivery for 21 pregnant patients with SCD and 19 HbAA pregnant controls with adapted to gestational age birth weight newborns. Histological and stereological analyses and scanning electron microscopy (SEM) of the placenta, and PlGF and sFlt1 measurements in blood were performed. RESULTS In the SCD group, the parenchyma-forming villi of placentas were thinner than in controls, and increased fibrinoid necrosis and an overabundance of syncytial knots were seen. SEM revealed elongated intermediate villous endings with a reduction in the number of terminal villi compared to controls, indicating a significant branching defect in SCD placentas. Finally, SCD patients had an imbalance in the angiogenic ratio of sFlt1/PlGF (p = 0.008) with a drop of PlGF concentrations. DISCUSSION We evidence for the first time both abnormal placenta morphology and altered sFlt1/PlGF ratio in SCD patients, uncorrelated with maintained placental efficiency and fetal growth.
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Affiliation(s)
- Anne-Gael Cordier
- Assistance Publique-Hôpitaux de Paris, Service de Gynécologie Obstétrique, Centre hospitalier universitaire Antoine Béclère, Université Paris-Sud, 92140, Clamart, France; Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; PremUp Foundation, Paris, F-75014, France; Centre de référence maladies rares. Syndromes drépanocytaires majeurs, thalassémies et autres pathologies rares du globule rouge et de l'érythropoïèse, Paris, France.
| | - Anne-Sophie Bouvier
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; PremUp Foundation, Paris, F-75014, France
| | - Francoise Vibert
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; PremUp Foundation, Paris, F-75014, France
| | - Jelena Martinovic
- Assistance Publique-Hôpitaux de Paris, Service de Fœtopathologie, Centre hospitalier universitaire Antoine Béclère, Université Paris-Sud, Clamart, France; INSERM, UMR, 1195, Université Paris Sud, Paris Saclay, France
| | | | - René Lai-Kuen
- Plateau technique Imagerie Cellulaire et Moléculaire (ICM), UMS, 3612, CNRS, US25 INSERM, Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, France
| | - Emmanuel Curis
- Service de biostatistiques et informatique médicale, Hôpital Saint-Louis, APHP, Paris, France; Laboratoire de biomathématiques, Faculté de pharmacie, Université Paris Descartes, France
| | - Thierry Fournier
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France
| | - Alexandra Benachi
- Assistance Publique-Hôpitaux de Paris, Service de Gynécologie Obstétrique, Centre hospitalier universitaire Antoine Béclère, Université Paris-Sud, 92140, Clamart, France; Centre de référence maladies rares. Syndromes drépanocytaires majeurs, thalassémies et autres pathologies rares du globule rouge et de l'érythropoïèse, Paris, France
| | - Katell Peoc'H
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; Assistance Publique-Hôpitaux de Paris, Laboratoire de Biochimie Clinique, HUPNVS, Hôpital Beaujon, Clichy and Université de Paris, UFR de Médecine Xavier Bichat, Paris, France
| | - Sophie Gil
- Université de Paris, INSERM UMR-S1139 (3PHM), Sorbonne Paris Cité, Paris, F-75006, France; PremUp Foundation, Paris, F-75014, France
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