- Email: [email protected]
Dysfunctions of the fetal non-adaptive immune system are involved in the pathogenesis of preeclampsia
32
FRIDAY,
SEPTEMBER
8
FC5.10.07 THE RELATION BETWEEN INTERCELLULAR ADHESION MOLECULE-l IS EXPRESSED ON FETAL VASCULAR ENDOTHELIUM AND THE ONSET OF PREECLAMPSIA R. Ovama, S. Chizuko. M. Morimasa, K. Teruo, Dept. OB/GYN, Iwate Medical University, Morioka, Japan.
FC5.10.09 LEPlJN IN PREECLAMPTIC WOMEN T. Lam (l), I. Schulz-Lobmevr (l), B.W. Harhnann (l), 0. Preye (l), P. Wagenbichler (2). (1)University of Vienna Medical School, Dept. OB/GYN, Vienna, Austria; (2) Ignaz-Semmelweis-Frauenklinik, Vienna, Austria
Objective: Intercellular Adhesion Melicule-1 (10&-l) is a member of the immunogloblin super family. ICAIv-1 is expressed on vascular endothelium throughout the decidua. We focused our experiments to investigate the differences in expression of ICAIv-1 on fetal vascular endothelium in placenta, and aimed to measure the circulating concentration of soluble ICAIv-1 (sICAIV-1). Study Methods: This study divided preeclampsia into the early onset type (EO; 20 to 31 weeks gestation) and late onset type (LO; over 32 weeks gestation). Placenta from 9 preterm pregnancies, 10 term pregnancies, 9 EO and 8 LO preeclampsia. The distribution of ICAIv-1 in fetal vascular endothelium was evaluated using immunocytochemical staining. Enzyme-Linked Imunosorbent Assay was used to measure concentration of sICAIV-1 in blood. Venous blood samples were taken from 21 non-pregnant women, 7 preterm pregnancies, 9 term pregnancies, 13 EO and 8 LO preeclampsia. Umbilical venous blood was taken from 8 preterm pregnancies, 10 term pregnancies, 7 EIO and 6 LO preeclampsia. Umbilical artery blood was taken from 9 preterm pregnancies, 11 term pregnancies, 9 EO and 8 LO preeclampsia. Results: sICAIV-1 concentration in preterm of maternal blood was higher than non pregnancies (216.2k21.4 ng/ml vs 139.2k9.5 ng/ml) (p
Objective: Leptin, the adpocyte-cpecific product of the ob gene, is thought to regulate appetite and body weight. Our aim was to find out if there was a difference in the circulationg levels of leptin in normal pregnancies, compared to pregnancies complicated by preeclampsia Study Methods: We included 36 pairs of women with either normal pregnancy (n=36) or preclampsia (n=36), matched 1:l for pregnancy body mass index and fetal gestational age at delivery. We compared the leptin concentrations in maternal and cord plasma. The Mann-Whitney-U test was used to compare leptin concentrations and to test other clinical anthropometric differences between groups. We also used the Spearmans coefficent and Pearson’s correlation analysis. Results: In Preeclamptic women the mean leptin concentrations were 8.3ng/mL, which is significantly lower (p
FC5.10.08 DYSFUNCTIONS OF THE FETAL NON-ADAPTIVE IMMUNE SYSTEM ARE INVOLVED IN THE PATHOGENESIS OF PREECLAMPSIA A. Steinborn, C. Sayehli, A. Scharf, C. Sohn, Dept. OB/GYN, University Hospital, Frankfurt, Germany. Objectives: Recently it was shown that preeclampsia is associated with a systemic activation of the non-adaptive maternal immune system. Here we demonstrate that similar inflammatory immune responses, mediated by fetal monocytes are involved in the pathogenesis of preeclampsia. Study Methods: Umbilical cord blood was collected form neonates after spontaneous term delivery (n=39), elective cesarean term delivery in the absence of labor (n=27), preterm delivery (~36 weeks) because of uncontrollable labor (n=35) and preterm delivery (~36 weeks) because of clinical symptoms of preeclampsia (n=23). Peripheral monocytes were analyzed for intracellular IL-6 staining by two color flow cytometry. Results: In comparison to cord blood obtained from neonates after elective term cesarean delivery (7.4% IL-6 positive monocytes, range 1.0.39.2%, p< 0.001) and cord blood obtained from neonates after preterm delivery (3.1% IL-6 positive monocytes, range 1.0.20.3%, p
FC5.11
TROPHOBLASTIC
DISEASE
AND UNUSUAL
TUMORS
FC5.11.01 REVISED COMBINED STAGING AND SCORING SYSTEM FOR TROPHOBLASTIC TUMOR E.I. Yale University School of Medicine, New Haven, CT, USA. On behalf of the International Gynecological Cancer Society (IGCS) and the International Society for the Study of Trophoblastic Tumors (ISSTD). Objectives: A combined staging and scoring system for trophoblastic tumor is presented that combines a revised International Federation of Gynecology and Obstetrics (FIGO) staging with an amended World Health Organization (WHO) scoring system. Study Methods: ISSTD and the IGCS help workshops with the major trophoblast centers throughout the world. An agreed staging/scoring system was promulgated to be presented to the FIG0 Staging Committee. Results: 1. The present FIG0 Staging I, II, III and IV will be retained. There will be no stage 0, this would necessitate re-staging when a diagnosis of postmolar hydatidiform tumor was made. 2. The risk factors of the present FIG0 staging will be replaced by the WHO score. Placental site tumor will be reported separately from other gestational trophoblastic tumors; the clinical condition, management and prognosis of the two are different. (2a) The risk score will be 0,1,2,3,4. (2b) ABO blood group risk factors are to be eliminated. (2~) The risk factors for liver metastases will be upgraded from 2 to 4. (2d) The remaining risk factors will be retained. 3. To implement this new system: (3a) To diagnose post-molar trophoblastic neoplasia the length of plateau will be 3 weeks or more (days 1,8,15) or a rise of hCG for 2 weeks or more (days 1,E) or an elevated hCG at 6 months. Assessment of plateau or rise is at the discretion of each physician. (3b) Lung metastases are diagnosed by chest X-ray; there is no objection to the use of CT scan. (3~) The middle risk group of the WHO system will be abandoned. Low-risk will be a score of 6 or less and highrisk a score of 7 or greater. Conclusion: This new FIG0 staging and scoring system should provide more uniform classification of trophoblastic tumor allowing better comparisons between trophoblast centers.
FRIDAY,
SEPTEMBER
8
FC5.10.07 THE RELATION BETWEEN INTERCELLULAR ADHESION MOLECULE-l IS EXPRESSED ON FETAL VASCULAR ENDOTHELIUM AND THE ONSET OF PREECLAMPSIA R. Ovama, S. Chizuko. M. Morimasa, K. Teruo, Dept. OB/GYN, Iwate Medical University, Morioka, Japan.
FC5.10.09 LEPlJN IN PREECLAMPTIC WOMEN T. Lam (l), I. Schulz-Lobmevr (l), B.W. Harhnann (l), 0. Preye (l), P. Wagenbichler (2). (1)University of Vienna Medical School, Dept. OB/GYN, Vienna, Austria; (2) Ignaz-Semmelweis-Frauenklinik, Vienna, Austria
Objective: Intercellular Adhesion Melicule-1 (10&-l) is a member of the immunogloblin super family. ICAIv-1 is expressed on vascular endothelium throughout the decidua. We focused our experiments to investigate the differences in expression of ICAIv-1 on fetal vascular endothelium in placenta, and aimed to measure the circulating concentration of soluble ICAIv-1 (sICAIV-1). Study Methods: This study divided preeclampsia into the early onset type (EO; 20 to 31 weeks gestation) and late onset type (LO; over 32 weeks gestation). Placenta from 9 preterm pregnancies, 10 term pregnancies, 9 EO and 8 LO preeclampsia. The distribution of ICAIv-1 in fetal vascular endothelium was evaluated using immunocytochemical staining. Enzyme-Linked Imunosorbent Assay was used to measure concentration of sICAIV-1 in blood. Venous blood samples were taken from 21 non-pregnant women, 7 preterm pregnancies, 9 term pregnancies, 13 EO and 8 LO preeclampsia. Umbilical venous blood was taken from 8 preterm pregnancies, 10 term pregnancies, 7 EIO and 6 LO preeclampsia. Umbilical artery blood was taken from 9 preterm pregnancies, 11 term pregnancies, 9 EO and 8 LO preeclampsia. Results: sICAIV-1 concentration in preterm of maternal blood was higher than non pregnancies (216.2k21.4 ng/ml vs 139.2k9.5 ng/ml) (p
Objective: Leptin, the adpocyte-cpecific product of the ob gene, is thought to regulate appetite and body weight. Our aim was to find out if there was a difference in the circulationg levels of leptin in normal pregnancies, compared to pregnancies complicated by preeclampsia Study Methods: We included 36 pairs of women with either normal pregnancy (n=36) or preclampsia (n=36), matched 1:l for pregnancy body mass index and fetal gestational age at delivery. We compared the leptin concentrations in maternal and cord plasma. The Mann-Whitney-U test was used to compare leptin concentrations and to test other clinical anthropometric differences between groups. We also used the Spearmans coefficent and Pearson’s correlation analysis. Results: In Preeclamptic women the mean leptin concentrations were 8.3ng/mL, which is significantly lower (p
FC5.10.08 DYSFUNCTIONS OF THE FETAL NON-ADAPTIVE IMMUNE SYSTEM ARE INVOLVED IN THE PATHOGENESIS OF PREECLAMPSIA A. Steinborn, C. Sayehli, A. Scharf, C. Sohn, Dept. OB/GYN, University Hospital, Frankfurt, Germany. Objectives: Recently it was shown that preeclampsia is associated with a systemic activation of the non-adaptive maternal immune system. Here we demonstrate that similar inflammatory immune responses, mediated by fetal monocytes are involved in the pathogenesis of preeclampsia. Study Methods: Umbilical cord blood was collected form neonates after spontaneous term delivery (n=39), elective cesarean term delivery in the absence of labor (n=27), preterm delivery (~36 weeks) because of uncontrollable labor (n=35) and preterm delivery (~36 weeks) because of clinical symptoms of preeclampsia (n=23). Peripheral monocytes were analyzed for intracellular IL-6 staining by two color flow cytometry. Results: In comparison to cord blood obtained from neonates after elective term cesarean delivery (7.4% IL-6 positive monocytes, range 1.0.39.2%, p< 0.001) and cord blood obtained from neonates after preterm delivery (3.1% IL-6 positive monocytes, range 1.0.20.3%, p
FC5.11
TROPHOBLASTIC
DISEASE
AND UNUSUAL
TUMORS
FC5.11.01 REVISED COMBINED STAGING AND SCORING SYSTEM FOR TROPHOBLASTIC TUMOR E.I. Yale University School of Medicine, New Haven, CT, USA. On behalf of the International Gynecological Cancer Society (IGCS) and the International Society for the Study of Trophoblastic Tumors (ISSTD). Objectives: A combined staging and scoring system for trophoblastic tumor is presented that combines a revised International Federation of Gynecology and Obstetrics (FIGO) staging with an amended World Health Organization (WHO) scoring system. Study Methods: ISSTD and the IGCS help workshops with the major trophoblast centers throughout the world. An agreed staging/scoring system was promulgated to be presented to the FIG0 Staging Committee. Results: 1. The present FIG0 Staging I, II, III and IV will be retained. There will be no stage 0, this would necessitate re-staging when a diagnosis of postmolar hydatidiform tumor was made. 2. The risk factors of the present FIG0 staging will be replaced by the WHO score. Placental site tumor will be reported separately from other gestational trophoblastic tumors; the clinical condition, management and prognosis of the two are different. (2a) The risk score will be 0,1,2,3,4. (2b) ABO blood group risk factors are to be eliminated. (2~) The risk factors for liver metastases will be upgraded from 2 to 4. (2d) The remaining risk factors will be retained. 3. To implement this new system: (3a) To diagnose post-molar trophoblastic neoplasia the length of plateau will be 3 weeks or more (days 1,8,15) or a rise of hCG for 2 weeks or more (days 1,E) or an elevated hCG at 6 months. Assessment of plateau or rise is at the discretion of each physician. (3b) Lung metastases are diagnosed by chest X-ray; there is no objection to the use of CT scan. (3~) The middle risk group of the WHO system will be abandoned. Low-risk will be a score of 6 or less and highrisk a score of 7 or greater. Conclusion: This new FIG0 staging and scoring system should provide more uniform classification of trophoblastic tumor allowing better comparisons between trophoblast centers.