137Cs掺入导致胎盘损伤的形态学和免疫组织化学特征。

A A Zhyvetska-Denysova, I I Vorobiova, N Ya Skrypchenko, T D Zadorozhna, V B Tkachenko, Yu M Bondarenko, S K Stryzhak
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引用次数: 0

摘要

目的:探讨137Cs掺入对妊娠结束后胎盘损伤的形态学和免疫组织化学特征。材料和方法:研究材料包括60例生殖功能丧失且有妊娠终止迹象的妇女的胎盘(第一组)和30例妊娠无并发症且无障碍的妇女的胎盘样本(对照组)。详细的研究需要将第一组胎盘样本分配到亚组。亚组1a包括38个胎盘,这些胎盘来自37-40周分娩的妇女,尽管有妊娠终止的迹象。1b亚组- 13例妊娠期28-36周+ 6天分娩妇女的胎盘。亚组1c - 9个胎盘样本来自妊娠期22-27周+ 6天分娩的妇女。用β-谱仪测定胎盘中137Cs的体积活性。使用标准技术研究胎盘的组织学。采用间接链亲和素过氧化酶检测方法,研究CD31 / PECAM-1、CD45 / T200 / LCA、CD56 / NCAM-1、CEA / CD66e Ab-2、Vimentin在胎盘中的表达。结果:胎盘累积137Cs。同位素的不同体积活度与怀孕情况有关。由于比质量超过1.1 Bq/kg的合并137Cs的作用,导致胎盘功能障碍。胎盘功能障碍的后果取决于137Cs的体积活性以及胎盘中适应性和代偿反应的保存。根据妊娠结束情况,建立了合并137Cs胎盘损伤的形态学和免疫组织化学特征。胎盘中癌胚抗原(CEA)的表达是妊娠结束不利的标志。结论:早产(PTP)是一种多因素病理,与免疫和神经内分泌调节的病理改变以及遗传、感染和环境因素有关,这些因素破坏了母体-胎盘-胎儿系统的适应机制。胎盘内137Cs照射是多因素生殖损失的因素之一。137Cs照射胎盘后,胎盘结构被扰乱,促炎细胞因子CD45和CD56活性升高,凝血级联被激活。极端影响取决于纳入胎盘的同位素的体积活性和器官的代偿能力。累积不超过1.0 Bq/kg的137Cs不会影响妊娠进程。4.5-10.4 Bq/kg 137Cs的内照射可诱发晚期早产。损害的性质与胎盘的“母体间质损伤”的类别相对应。137Cs的体积活性超过10.4 Bq/kg可能是早期早产和产前胎儿死亡的原因。与此同时,胎盘的母体和胎儿结构也会受到损害。vimentin的表达是137Cs内照射造成胎盘破坏的标志,其比重超过4.5 Bq/kg。PTP妇女胎盘结构中CEA的表达是胎盘内137Cs辐射(活性超过4.5 Bq/kg)导致早产和胎儿死亡的独特发现和标志。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL FEATURES OF PLACENTAL DAMAGE DUE TO THE INCORPORATION OF 137Cs.

Objective: to investigate the morphological and immunohistochemical features of placental damage due to theincorporation of 137Cs depending on the scenario of pregnancy completion.

Materials and methods: The study material consisted of placentas from 60 women with reproductive losses inanamnesis and signs of termination of the current pregnancy (first group) and placental samples from 30 women with an uncomplicated gestation and an unencumbered anamnesis (control group). The detailed study required the distribution of placental samples from the first group into subgroups. Subgroup 1a included 38 placentas from women who gave birth at 37-40 weeks, despite signs of termination of the current pregnancy. Subgroup 1b - placentas of 13 women who gave birth at a gestation period of 28-36 weeks + 6 days. Subgroup 1c - 9 placental samples from women who gave birth at a gestation period of 22-27 weeks + 6 days. The volumetric activity of the 137Cs in the placentas was measured using β-spectrometer. The histology of the placenta was studied using a standard technique. The following expressions were studied in placenta: CD31 / PECAM-1, CD45 / T200 / LCA, CD56 / NCAM-1, CEA / CD66e Ab-2, Vimentin, using indirect streptavidin peroxidase detection method.

Results: Placentas accumulate 137Cs. The different volumetric activity of the isotope correlates with scenarios of pregnancy. Due to the action of incorporated 137Cs with a specific mass of more than 1.1 Bq/kg, placental dysfunction develops. The consequences of placental dysfunction depend on the volumetric activity of the 137Cs and the preservation of adaptive and compensatory reactions in the placenta. Morphological and immunohistochemical features of placental damage to incorporated 137Cs were established, depending on the scenario of completion of pregnancy. A marker of unfavorable completion of pregnancy is the expression of a carcinoembryonic antigen (CEA) in the placenta.

Conclusions: Premature termination of pregnancy (PTP) is a multifactorial pathology associated with pathological changes in immune and neuroendocrine regulation and hereditary, infectious, and environmental factors that disrupt the adaptation mechanisms in the mother-placenta-fetus system. Intraplacental irradiation of 137Cs is one of the factors in the multifactorial nature of reproductive losses. As a result of intraplacental irradiation of 137Cs, the architecture of the placenta is disturbed, the activity of pro-inflammatory cytokines CD45 and CD56 increases, and the coagulation cascade is activated. Extreme effects depend on the volumetric activity of the isotope incorporated in the placenta and the organ's compensatory capacity. Accumulation of up to 1.0 Bq/kg 137Cs does not affect the course of gestation. Internal irradiation with an activity of 4.5-10.4 Bq/kg 137Cs triggers late preterm labor. The nature of the damages corresponds to the category of «lesion of the maternal stroma» of the placenta. The volumetric activity of 137Cs over 10.4 Bq/kg is a probable cause of early preterm labor and antenatal fetal death. At the same time, the maternal and fetal structures of the placenta suffer damage. Expression of vimentin is a marker of placental destruction due to internal irradiation of 137Cs with a specific gravity of more than 4.5 Bq/kg. Expression of CEA in the structures of the placenta of women with PTP is a unique find and marker of premature birth and antenatal fetal death with intraplacental irradiation of 137Cs with an activity of more than 4.5 Bq/kg.

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Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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