PubMed · 3724062
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E Angel, J R Davis, R B Nagle. 1986. Decidual cells.. https://pubmed.ncbi.nlm.nih.gov/3724062/
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Transforming growth factor beta (TGF beta) produced at the human fetomaternal interface has been shown to play a crucial role in controlling trophoblast invasion of the uterus. Decorin, a naturally occurring chondroitin-dermatan sulphate proteoglycan which binds TGF beta can inhibit its activity. In this study, immunohistochemical techniques were used to determine the locations of TGF beta and decorin within the human placenta and decidua throughout normal gestation. In addition, sites of TGF beta 1 mRNA synthesis were identified in early and late placenta by in situ hybridization. Results revealed the presence of immunoreactive TGF beta in the cytoplasm of villous syncytiotrophoblast and extravillous trophoblast cells throughout gestation. TGF beta immunostaining was absent from villous cytotrophoblast at all gestational ages examined. The extracellular matrix (ECM) of the villous core at all stages of gestation and cells of the cytotrophoblastic shell of the term placenta were immunoreactive for TGF beta. Within decidual tissue, TGF beta was primarily localized in the ECM during the first trimester and only a small proportion of decidual cells exhibited intracellular labelling. At later gestational ages the majority of decidual cells showed intracellular labelling accompanied by a decrease in ECM staining. This switch may reflect increased TGF beta synthesis by the decidual cells, decreased release, or altered TGF beta binding to one or more ECM proteins. In situ hybridization indicated that TGF beta 1 mRNA was primarily localized to the syncytiotrophoblast cell layer with low intensity signals present in extravillous trophoblast cells, in trophoblast cell columns, and in large decidual cells. At term, TGF beta 1 mRNA was located in both the syncytiotrophoblast and villous mesenchymal cells. Decorin was immunolocalized to the ECM of the mesenchymal core of the chorionic villi throughout gestation and no immunoreactivity was observed in either villous or extravillous trophoblast. In the first trimester decidua, decorin was localized to the ECM whereas decidual cells, decidual leucocytes, and the uterine epithelium were negative. At later gestational ages, the ECM as well as a few decidual cells displayed weak immunoreactivity. A strong co-localization of TGF beta and decorin in the ECM of first trimester decidual tissue suggests that decorin may aid TGF beta storage or limit its activity in the ECM.
Uterine fluid samples from 109 patients undergoing in-vitro fertilization and embryo transfer were obtained so as to examine the relationship between the uterine fluid concentration of human decidua-associated protein (hDP) 200 and the implantation rate. The sampling was performed on the day of embryo transfer with a Wallace catheter, used for the testing of cervical patency before embryo replacement. The implantation rate, as well as the pregnancy rate, demonstrated a significantly positive correlation with the concentration of hDP 200 in the uterine fluid, measured just before embryo transfer. These results indicate that hDP 200, identified as a rheumatoid factor secreted by the endometrium, may be involved in the implantation process.
The ultrasonographic evaluation of ectopic pregnancy is fraught with potential pitfalls in image interpretation. Though recent advances in sonographic techniques have improved the precision and scope of the study, considerable expertise is still needed to perform and interpret the sonogram for a suspected ectopic gestation. In this article, we review the ultrasonic evaluation for ectopic pregnancy, emphasizing the difficulties in diagnosis.