Loss of placental thrombomodulin in oocyte donation pregnancies
Pregnancies conceived through oocyte donation show loss of placental thrombomodulin, which is associated with increased coagulation and inflammation. This might explain the increased risk for developing preeclampsia after oocyte donation.
Volume 107, Issue 1, Pages 119-129
Authors:
Manon Bos, B.Sc., Hans J. Baelde, Ph.D., Jan A. Bruijn, M.D., Ph.D., Kitty W.M. Bloemenkamp, M.D., Ph.D., Marie-Louise P. van der Hoorn, M.D., Ph.D., Rosanne J. Turner, B.Sc.
Abstract:
Objective
To investigate whether thrombomodulin dysregulation is involved in the development of preeclampsia after oocyte donation (OD). Women who become pregnant after OD are prone to develop preeclampsia, a syndrome characterized by an aberrant immunologic response, hypercoagulability, and endothelial dysfunction. A mediator of inflammation and coagulation is thrombomodulin, which has a possible role to play in this syndrome.
Design
Case-control study.
Setting
Not applicable.
Patient(s)
Placentas from 82 women with an uncomplicated pregnancy (48 naturally conceived, 21 IVF, and 33 OD pregnancies) and 9 women with an OD pregnancy complicated by preeclampsia have been studied.
Intervention(s)
None.
Main Outcome Measure(s)
Abundances of thrombomodulin protein and vitamin D receptor (VDR) were determined using immunohistochemistry; mRNA expression was determined using quantitative polymerase chain reaction.
Result(s)
Placental thrombomodulin protein abundance was lower in OD pregnancies (diffuse pattern in 45%) than in controls (diffuse pattern in 96%). Placental thrombomodulin mRNA expression was lower in OD pregnancies complicated by preeclampsia (0.72 ± 0.47) compared with in uncomplicated OD pregnancies (0.43 ± 0.18). Thrombomodulin expression correlated with inflammation and coagulation. VDR expression was decreased in OD pregnancies complicated by preeclampsia and was correlated with thrombomodulin mRNA.
Conclusion(s)
Pregnancies conceived through OD lose placental thrombomodulin expression. This loss is associated with an increased coagulation and inflammation and indicates that endothelial protection is diminished in OD pregnancies, which might be an explanation for the increased risk for preeclampsia. Vitamin D metabolism is dysregulated in OD pregnancies and might be a target for therapy.
