Unterschiede in der Trophoblastinvasion bei der Tubar- und Intrauteringravidität

Zusammenfassung

Vergleicht man die Trophoblastinvasion bei der Extrauteringravidität (EUG) mit der Intrauteringravidität (IUG), so lassen sich Gemeinsamkeiten mit der IUG finden bezüglich der Expression des Human leukocyte antigen (HLA)-G in den extravillösen Trophoblastzellen und der beim Umbau der Extrazellulärmatrix beteiligten Proteasen (MT1-MMP, MT2-MMP, MMP-1, TIMP-2), die ebenfalls in den extravillösen Trophoblastzellen lokalisiert sind. Auch die bei der Implantation beteiligten Zytokine sind vergleichbar (LIF, TGFβ, Interferone, EGF). Jedoch fehlen die für die IUG typischen NK-Zellen.

Bei der Tubargravidität kann zwischen Tubarabort und vitaler Tubargravidität unterschieden werden. Dabei zeigt die vitale Tubargravidität im Gegensatz zum Tubarabort eine verstärkte Invasivität gegenüber der IUG. Kennzeichnend hierfür ist, dass die für die IUG typische strikte Trennung zwischen dem proliferativen und dem invasiven Phänotyp der Trophoblastzellen aufgehoben ist. Hierdurch kommt es zu einer Überlappung zwischen Proliferations- und Invasionszone mit entsprechend früher apolarer Matrixsekretion und vorzeitigem Switch hin zur Expression invasionsassoziierter Integrine.

Abstract

If trophoblast invasion in ectopic pregnancy is compared with intrauterine pregnancy similarities can be observed concerning the expression of human leukocyte antigen (HLA)-G in extravillous trophoblast cells and concerning the proteases which are involved in the remodelling of the extracellular matrix (MT1-MMP, MT2-MMP, MMP-1, TIMP-2) and which are also located in extravillous trophoblast cells. The same is true for the cytokines involved in implantation (LIF, TGFβ, interferons, EGF). However, NK cells which are typical for intrauterine pregnancy are absent.

Ectopic pregnancies can be divided into viable tubal pregnancies and tubal abortions. In viable tubal pregnancies trophoblast invasion is enhanced compared to intrauterine pregnancy and to tubal abortion. It is characteristic for those cases that the strict discrimination between the proliferative and the invasive phenotype of trophoblast typical for intrauterine pregnancies is abolished. So proliferative and invasive zone are overlapping with earlier apolar matrix secretion and expedited switch towards invasion-associated integrin expression.

Trophoblastinvasion - Tubargravidität - Intrauteringravidität

Trophoblast invasion - Tubal pregnancy - Intrauterine pregnancy

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