
INCREASED EXPRESSION OF PENTRAXIN 3 IN
PLACENTAL TISSUES FROM PATIENTS WITH
UNEXPLAINED RECURRENT PREGNANCY LOSS Zeybek S1,*, Tepeli E2, Cetin GO3, Caner V3, Senol H4, Yildirim B2, Bagci G3 *Corresponding Author: Selcan Zeybek, M.D., Department of Medical Genetics, Erzurum Regional
Training and Research Hospital, Cat Volu Street, 25070, Erzurum, Turkey. Tel.: +90-506-399-2644.
Fax: +90-442-232-5025. E-mail: selcankesan@yahoo.com page: 21
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INTRODUCTION
According to the American College of Obstetricians
and Gynecologists [1], recurrent pregnancy loss is a disease,
defined as two or more failed pregnancies. Recurrent
pregnancy loss is one of the most frustrating and difficult
areas of reproductive medicine because up to 50.0% of
cases lack clearly defined etiology [2]. Common conditions
that have been associated with recurrent pregnancy losses
include uterine abnormalities, parental chromosomal aberrations,
various endocrine disturbances and the presence
of antiphospholipid antibodies [3,4]. Uncontrolled
inflammatory response is thought an important mechanism
underlying development of pregnancy complications such
as unexplained pregnancy loss, preeclampsia, fetal growth
restriction and death [5,6]. In the placenta, innate and
adaptive immune responses influence the balance between
anti- and pro-inflammatory decidual environments. These
inflammatory changes are essential to various processes
that are required for successful embryonic implantation,
such as trophoblast invasion, angiogenesis and placental
growth [7].
Pentraxins are a superfamily of evolutionarily conserved
multifunctional pattern-recognition proteins that
play roles in innate humoral immunity. Serum amyloid
P component and C reactive protein constitute the short
arm of the pentraxin superfamily. Pentraxin 3 (PTX3) is a
prototype member of long arm that contains an additional N-terminal domain. Unlike classic pentraxins made in the
liver, PTX3 is produced locally by a number of different
cells such as mononuclear cells, dendritic cells and endothelial
cells [8]. Pentraxin 3 is a multifunctional protein
that interacts with various ligands, including elements of
the complement system such as C1q, factor H, C4 binding
protein, ficolins and mannose-binding lectin; growth factors
such as fibroblast growth factor 2; adhesion molecules
such as P-selectin; extracellular matrix components such
as inter-α-trypsin inhibitor; tumor necrosis factor-inducible
gene-6 and fibrin; apoptotic cells, and pathogens such
as Klebsiella pneumoniae and Aspergillus fumigatus [9].
Hence, PTX3 plays important roles in innate immunity,
complement activation, inflammation, matrix deposition,
angiogenesis, vascular remodeling, platelet activation,
antimicrobial resistance and tissue repair [8]. Pentraxin
3 also behaves as an acute-phase response protein that
is rapidly induced from low blood levels in response to
inflammation. Pentraxin 3 expression levels have also been
correlated with disease severity under conditions of sepsis,
acute myocardial infarction, atherosclerosis, autoimmune
disorders and preeclampsia [10,11].
During pregnancy, PTX3 is expressed in amniotic epithelial,
chorionic mesoderm, terminal villous trophoblast
and placental perivascular stromal tissues, and is increasingly
expressed during pregnancy and peaks during labor
[12,13]. However, no previous studies have shown PTX3
expression patterns in placental tissues of patients with
unexplained recurrent pregnancy loss (URPL). Herein,
we determined PTX3 expression levels in patients with
URPL and compared these with those in a control group
of subjects with a history of healthy live births.
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