Expression of tumor associated antigens CA 15-3 and CA 19-9 in trophoblast of the normal human placenta

Mucin 1 (MUC1) is abundantly expressed by various organs, including human placenta and endometrium. Since glycan modifications of MUC1 are potentially relevant for physiological as well as pathological processes, this study was aimed at establishing an expression profile of two MUC1 glycoepitopes, CA 15-3 and CA 19-9, in trophoblast throughout pregnancy. Immunohistochemical analysis of normal placenta demonstrated that trophoblast cells express both mucin antigens throughout gestation with a distinct staining pattern. The staining of villous trophoblast was non-uniform for both antigens, and stronger for CA 15-3. Only a proportion of extravillous trophoblast of the cell column, in decidual stroma or lining blood vessels was also stained. Whether the studied MUC 1 glycoforms can be linked to trophoblast cells invasion remains to be established.

[Surgical treatment of a 5 month pregnancy in the rudimentary uterine cornu]

Cornual ectopic pregnacy is rare clinical entity with high maternal mortality. In all cases surgical treatment is indicated, and taking care of most important complication--haemorrhagic shock. Therapeutic approach is individual and depending of simptomatplogy, gestational age of pregnancy and condition of the patient in time of diagnosis. Authors are presenting the case of cornual ectopic pregnancy of five months.

[Acute renal failure after cesarean section as a consequence of hematoma of the retropubic space of Retzius]

Acute renal failure is rare postoperative complication of cesarean section. Postrenal acute renal failure is corectible ant it shoud be done immediately in order to avoid secundary destruction of renal parenchim. Surgical techniques shoud be directed to achieve adequat haemostasis, espetialy at low transverse Pfannenstiel incision, as well as in tender manipuliating with tissues to prevent unnecessery formation of dead space and tissues devitalisation. Authors are presenting the case of acute renal failure after cesarean section as a consequence of hematoma of the retropubic space of Retzius and way of treatment.

Galectin-1 and galectin-3 in the trophoblast of the gestational trophoblastic disease

While the presence and distribution of galectin-1 and galectin-3 in different normal trophoblast cell populations is known, no information is available regarding their occurrence in malignant trophoblast of gestational trophoblastic disease (GTD). Galectins-1 and -3 have, however, been implicated in malignancies of other tissues. Immunoreactivity for these galectins in the transformed trophoblast of invasive mole (n = 8), choriocarcinoma (n = 7) and one case of placental site trophoblastic tumor (PSTT) was compared to that of the invasive trophoblast of the normal first trimester of pregnancy implantation sites (n = 9). A large proportion of the transformed trophoblast cells of all GTD studied were positive for galectin-1 and galectin-3. Immunoreactivity was scored semiquantitatively to include both the prevalence among the trophoblast cells and the intensity of staining. Immunoreactivity for both galectin-1 and galectin-3 in gestational trophoblastic disease is increased (significant differences at p < 0.05, Mann-Whitney Rank Sum Test). This finding may suggest a possible implication of galectins-1 and -3 in the invasiveness of the transformed trophoblastic cell, although the exact physiological significance of this finding remains to be determined.

Expression of galectin-3 and carcinoembryonic antigen in the trophoblast of the gestational trophoblastic disease

PURPOSE

Galectin-3, an endogenous beta-galactoside- binding protein, has been implicated in the regulation of many physiological and pathological cellular processes through specific interactions with complementary ligands. The level of galectin-3 expression has been correlated with metastatic potential in many tumor types. The present study was designed to investigate possible correlation of the expression of galectin-3 with carcinoembryonic antigen (CEA), one of the putative galectin-3 ligands, in the transformed trophoblast of the gestational trophoblastic diseases (GTDs) compared to the invasive trophoblast (interstitial and endovascular) of the normal first trimester of pregnancy placenta.

MATERIALS AND METHODS

Double immunohistochemistry was used to examine paraffin sections of 9 specimens of normal placenta, 8 cases of invasive mole and 7 cases of choriocarcinoma. Immunoreactivity was scored semiquantitatively to include both the percent of trophoblast cells stained as well as the intensity of staining.

RESULTS

Data presented here demonstrate similar patterns of expression for galectin-3 and CEA in transformed GTDs trophoblastic cells, as well as in normal invasive trophoblast. Upregulation of galectin-3 in transformed GTDs trophoblast was followed by high levels of CEA expression in the same tissue specimen (significant differences at < 0.05, Mann-Whitney Rank Sum Test).

CONCLUSION

These results may point to the CEA as one of the ligands for galectin-3 in transformed trophoblast, which merits further investigation.

Intravenous immunoglobulin preparations as immunomodulatory agents

Certain immunopathologic conditions, such as hypersensitivity and autoimmune diseases, are characterized by quantitative and/or qualitative alterations of immune reactions. It is now believed that such immunologic disturbances generate from inadequate internal control and regulation of immunologic reactivity. Important member of the complex regulatory network that supervises an immune response are antibodies themselves. Since antibody is bifunctional molecule, its regulatory action deals with two separate molecular structures denoted as Fab and Fc portion. By Fab fragment, antibody interferes with the reaction with antigens, or participates in the regulatory idiotype/antiidiotype interactions. Fc-mediated regulation includes influence on complement activation cascade, formation and clearance of immune complexes, phagocytosis, ADCC activity, T- and B-cell function, cytokine profile, etc. In general, antibody triggers immune reactions, but also has the capacity to suppress them. Exogenous antibodies are likely to elicit similar effects on immune processes. Actually, it has been demonstrated that intravenously given immunoglobulins, particularly high-dose IgG, effectively combat harmful immune response in some chronic inflammatory and autoimmune disorders. Hence, preparations of immunoglobulins for intravenous use (IVIG) can be considered as an immunomodulatory agent. To achieve the property of modulating the immune response, IVIG products must contain intact (7S) IgG molecule and maintain sufficient concentrations in plasma.

[Rational for the use of human immunoglobulins in clinical practice]

The Clinic for Rheumatology and Clinical Immunology of the Military Medical Academy, with the participation of the hosts and experts from eminent Yugoslav institutions, in April 1997 organized the symposium on two current and trendy subjects from clinical immunology: "Antiphospholipid syndrome" and "The use of polyvalent intravenous immunoglobulins in the clinical praxis". This paper summarizes the contemporary knowledge about the structure and biological activity of immunoglobulins, methods for their production, different pharmacokinetic and pharmacodynamic characteristics of two types (5S and 7S) IVIG preparations, etc. We pointed out three basic groups of indications for IVIG clinical use: 1) substitutional therapy in the primary and secondary immunodeficiencies; 2) adjuvant therapy for severe infections; 3) immunomodulation in autoimmune diseases. Particular emphasis was put on currently known mechanisms of immunosuppressive action of IVIG in autoimmune diseases. Except for presently accepted indications for their use (idiopathic thrombocytopenic purpura and Kawasaki syndrome) we mentioned about 40 different diseases in hematology, neurology, rheumatology and other branches of medicine, from neonatology to transplantology, in which IVIG had shown some efficacy. Possibilities of different therapeutic modalities and the choice of diverse pharmacokinetic and pharmacodynamic effects, benefit the very wide spectrum of diseases, while minimal incidence of adverse effects suggested them to be the therapy of the future in the clinical practice.