Original contributionsThe placental-umbilical unit in sickle cell disease pregnancy: A model for studying in vivo functional adjustments to hypoxia in humans☆
Section snippets
Tissue and blood samples
Twenty fresh human umbilical cords, each 25 cm long, were collected immediately after delivery from pregnant race-matched women (age 18 to 40 years) who delivered in the maternity ward of the University Hospital Center of Guadeloupe. Umbilical vein blood was also collected. In each case, 2 cm of umbilical cord was fixed in formalin and embedded in paraffin or frozen rapidly in liquid nitrogen and stored at −80°C until used, with the remaining cord used for EC isolation (unpublished
Clinical characteristics of the placenta in SCD pregnancy
Although evaluation of pregnancy per se was not the primary objective of the study, macroscopic and microscopic examinations of each placenta were performed. The mean weight was similar in control (440.8 ± 73.1 g) and SCD pregnancies (452.4 ± 89 g), with both groups demonstrating good concordance between maturity and term. However, when compared with controls, more vascular anomalies were detected in SCD pregnancies, mainly in the parenchyma localized between the fetal and maternal surfaces.
Discussion
Despite the physiological and biological mechanisms of pregnancy, we believe that the atypical phenotype observed in SCD is largely due to hypoxia. Our major observations are as follows:
- 1.
The hypoxic environment does not induce inflammatory responses in the placental-umbilical unit.
- 2.
SCDPvein allows the study of in vivo responses to hypoxia in humans.
- 3.
PECAM-1 and VEGF may turn out to be therapeutic targets in SCD induced-hypoxia.
Hypoxic stress often precedes or accompanies tissue inflammation,
Acknowledgements
The authors thank E. Janky and the midwives of the maternity ward of the Hospital Center of Guadeloupe, as well as Dr C. Chicot-Leturdu of the sickle cell center. In memory of C. Berchel, former director of INSERM 516.
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Supported by grants from INSERM, Guadeloupe Region, and the University of Antilles and Guyana.