PMID- 25820373
OWN - NLM
STAT- MEDLINE
DCOM- 20150826
LR  - 20181113
IS  - 1432-2307 (Electronic)
IS  - 0945-6317 (Linking)
VI  - 466
IP  - 6
DP  - 2015 Jun
TI  - Placental C4d deposition is a feature of defective placentation: observations in 
      cases of preeclampsia and miscarriage.
PG  - 717-25
LID - 10.1007/s00428-015-1759-y [doi]
AB  - Placental C4d deposition is frequent in preeclampsia, and shallow placentation is 
      a characteristic of both preeclampsia and miscarriage. This study was conducted 
      to determine the relationship among placental C4d, maternal human leukocyte 
      antigen (HLA) antibodies, and placental pathology in preeclampsia and miscarriage 
      cases. The patient population (N = 104) included those with (1) preterm 
      preeclampsia with fetal growth restriction (PE-FGR; n = 21), (2) preterm 
      preeclampsia (PE; n = 20), (3) spontaneous preterm delivery (sPTD; n = 39), and 
      (4) miscarriage (n = 24). C4d immunohistochemistry was performed, and the 
      presence of maternal plasma HLA antibodies was examined. C4d staining of the 
      syncytiotrophoblast was more frequent in PE-FGR patients (76.2 %) than in PE 
      (10.0 %; p < 0.001) and sPTD (2.6 %; p < 0.001) patients. Maternal HLA 
      antibody-positive rate was not different among the study groups. There was a 
      significant correlation between C4d immunoreactivity and placental pathology 
      consistent with maternal vascular underperfusion (p < 0.001) but not with 
      maternal HLA antibody status. In miscarriages, the positive rates of C4d, HLA 
      class I, and HLA class II antibodies were 58.3, 25.0, and 12.5 %, respectively. 
      There was no correlation between the presence of maternal HLA class I or II 
      antibodies and placental C4d immunoreactivity. This study confirms frequent 
      placental C4d deposition in preeclampsia with fetal growth restriction and 
      miscarriage. The association between placental C4d deposition and pathological 
      findings of maternal vascular underperfusion suggests that C4d staining of the 
      syncytiotrophoblast is a consequence of defective placentation rather than of a 
      specific maternal immune response against fetal HLA. The study also demonstrates 
      the usefulness of C4d as a biomarker of placentas at risk.
FAU - Kim, Eun Na
AU  - Kim EN
AD  - Department of Pathology, Asan Medical Center, University of Ulsan College of 
      Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea.
FAU - Yoon, Bo Hyun
AU  - Yoon BH
FAU - Lee, Joong Yeup
AU  - Lee JY
FAU - Hwang, Doyeong
AU  - Hwang D
FAU - Kim, Ki Chul
AU  - Kim KC
FAU - Lee, JoonHo
AU  - Lee J
FAU - Shim, Jae-Yoon
AU  - Shim JY
FAU - Kim, Chong Jai
AU  - Kim CJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150328
PL  - Germany
TA  - Virchows Arch
JT  - Virchows Archiv : an international journal of pathology
JID - 9423843
RN  - 0 (Complement C4)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Abortion, Spontaneous/etiology/*pathology
MH  - Adult
MH  - Complement C4
MH  - Female
MH  - Fetal Growth Retardation/etiology/pathology
MH  - HLA Antigens/metabolism
MH  - Humans
MH  - Immunohistochemistry
MH  - Placenta/pathology
MH  - Placenta Diseases/*pathology
MH  - Placentation/*physiology
MH  - Pre-Eclampsia/etiology/*pathology
MH  - Pregnancy
MH  - Tissue Array Analysis
EDAT- 2015/03/31 06:00
MHDA- 2015/08/27 06:00
CRDT- 2015/03/31 06:00
PHST- 2014/10/06 00:00 [received]
PHST- 2015/03/11 00:00 [accepted]
PHST- 2015/02/08 00:00 [revised]
PHST- 2015/03/31 06:00 [entrez]
PHST- 2015/03/31 06:00 [pubmed]
PHST- 2015/08/27 06:00 [medline]
AID - 10.1007/s00428-015-1759-y [doi]
PST - ppublish
SO  - Virchows Arch. 2015 Jun;466(6):717-25. doi: 10.1007/s00428-015-1759-y. Epub 2015 
      Mar 28.