Diagnostic approach and study of potential haematological disorders in miscarried embryos with established chorioamnionitis in the second trimester of development (Doctoral thesis)

Παπαδόπουλος, Εμμανουήλ Νικ.

Chorioamnionitis is a serious complication of pregnancy, found in fetal membranes, and is associated with a high rate of fetal morbidity and mortality of 43-45.5% in the second trimester of development. This period coincides with intense haematopoietic activity in the liver, spleen and thymus gland of the fetus, and immune system initiation. The objective of this study was: 1)To evaluate immunohistochemically, in the 2nd trimester of growth (beginning, middle and end), the haematopoietic activity in liver, spleen and thymus gland of human embryos. Embryos with severe acute chorioamnionitis and embryos without inflammatory changes in the fetal membranes were evaluated. 2) To evaluate embryos with concomitant chorioamnionitis and embryos without inflammatory response, changes in the expression of the cell adhesion molecules CD44, E-Cadherin and E-Selectin. The study consisted of one hundred and twenty embryos (thirty embryos were used as controls and ninety embryos associated with severe changes of acute chorioamnionitis) belonging to the collection of the Laboratory of Histology and Embryology of the Democritus University of Thrace in Alexandroupolis. A statistical analysis, a comparative study of our results, and conclusions on the side effects of acute chorioamnionitis on the haematopoiesis and lymphopoiesis of the embryos were performed. The basic technique applied was that of histochemistry (Hematoxylin & Eosin staining) and immunohistochemistry. The results of immunohistochemical analysis showed, in all three organs examined, increased expression for the haematopoietic cell lines in embryos associated with severe changes of acute chorioamnionitis. An exception was the reduced expression for macrophages. In contrast, the results of immunohistochemical analysis for lymphocytes showed a significant decrease in the expression of T-cytotoxic CD8+ lymphocytes and CD3+ T-lymphocytes, both in the thymus gland and in the spleen, in embryos with concomitant changes of acute chorioamnionitis. Analogous results were also found in the analysis of the findings for CD44, E-Cadherin and E-Selectin cell adhesion molecules, expressed in haematopoietic cells, lymphocytes and vascular endothelial cells. The pathogenetic mechanism responsible for the changes in haematopoiesis and lymphopoiesis in the cases of acute chorioamnionitis, seems to be related to the release of toxic molecules and cytokines that damage and alter the physiological anatomical and functional activities of the liver, spleen and thymus.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Subject classification: Θύμος αδένας
Keywords: Χοριοαμνιονίτιδα,Ήπαρ,Σπλήνας,Θύμος,Διαταραχές εξωμυελική αιμοποίηση,Chorioamnionitis,Liver,Spleen,Thymus,Changes extramedullary haemopoiesis
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/29468
Appears in Collections:Διδακτορικές Διατριβές

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