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DOI: 10.1055/s-0040-1713215
Features of Endometrial Stem Cells in Placenta Accreta Spectrum Disorders
Background: Placenta accreta spectrum disorders (PAS) feature abnormally invasive implantation of placenta and absence of decidua. Occurrence of PAS is strongly associated with damaged endometrial- myometrial tissue (after uterine surgery or C-section). Due to the absence of decidua, trophoblasts uncontrollably invade the myometrium. Endometrial regeneration in premenopausal women is maintained by the so-called endometrial mesenchymal stem cells (eMSC) upon the exposure to estrogen and progesterone. eMSC located in the perivascular niche of functionalis and basalis express Sushi Domaine Containing 2 (SUSD2). The role of SUSD2+ eMSC in both pregnancy and post-operative regeneration is unknown. The aim of this study is to characterize the capacity of SUSD2+ eMSC isolated from the uterus at term pregnancy and to compare to those isolated from PAS and non-pregnant uterine samples. We hypothesize that the capacity of eMSC is hindered in the PAS samples in comparison to non-PAS controls.
Methods: eMSC were isolated from the endometrium of pregnant, non-pregnant and PAS uterine samples and underwent magnetic bead separation using W5C5 antibody which binds SUSD2 protein. Further, SUSD2+ cells were differentiated, and colony-forming unit assay was performed. Additionally, location of SUD2+ eMSC was determined with immunohistochemistry.
Results: Results depict that SUSD2+ eMSC persist throughout pregnancy and are located in the perivascular niche. Histological sections reveal lesser abundance of SUSD2+ eMSC in pregnant and PAS samples compared to non-pregnant samples. Furthermore, the fraction of isolated SUSD2+ cells is smaller in PAS in comparison to the fractions of pregnant and non-pregnant isolations. However, SUSD2+ eMSC from PAS-samples exhibit significantly higher cloning efficiency compared to the SUSD2+ eMSC from pregnant and non-pregnant uterine samples (p < 0.001). eMSC exhibit a similar differentiation potential in all groups.
Conclusion: Further experiments on SUSD2+ eMSC are needed to determine if our results are an effect or a cause of PAS. Determination of the role of stem cells in PAS could contribute to its prevention in the future.
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Interessenkonflikt
The authors have no conflict of interest.
Publication History
Article published online:
02 June 2020
Georg Thieme Verlag KG
Stuttgart · New York