Endocrine Placenta



During the 9-month time period of human pregnancy, the placenta is a pleiotropic regulator of the intrauterine environment. The principle cell type of the placenta, trophoblast, produces a wide variety of hormones that signal maternal, placental, and fetal tissues in an autocrine, paracrine, and endocrine fashion. The placenta can be separated into three distinct compartments. The implantation site is where trophoblast invades the uterine vessels to form a maternal circulation. The interhemal membrane is where trophoblast modulates maternal metabolism, transports substrates to the fetus, and protects the fetus from potentially harmful maternal agents. The extraplacental membranes regulate prostaglandins and other mediators that trigger labor. In addition to their involvement in normal physiology at these maternal–fetal interfaces, the evaluation of placental hormones also plays a critical role in the detection of Down syndrome, in the prediction of pregnancy complications such as preeclampsia and preterm labor, and in understanding the long-term complications of intrauterine deprivation. Finally, as with specific cellular lineages in other organs, trophoblast can undergo neoplastic transformation (gestational trophoblastic disease). Diagnostic immunohistochemistry for placental hormones and measurement of serum levels of placental hormones following therapy play important roles in diagnosis and treatment of specific tumors and precursor lesions arising at each of these three locations.


Gestational trophoblastic disease Hormones Invasion Labor Placenta Transport Trophoblast 



a disintegrin and metalloproteinase


angiopoietin 2


angiotensin receptor, type 1


cyclic adenosine monophosphate




carcinoembryonic antigen-like cellular adhesion molecule


corticotropin-releasing hormone


corticotropin-releasing hormone binding protein










epithelioid trophoblast


epithelioid trophoblastic tumor


endovascular trophoblast


human chorionic gonadotropin


human growth hormone-variant


human placental lactogen


hypoxia-induced factor 1


11-beta hydroxysteroid dehydrogenase


insulin-like growth factor

IGF-II/MBP receptor

insulin-like growth factor II/mannose-binding protein receptor


insulin-like growth factor binding protein


intermediate trophoblast


low-density lipoprotein




plasminogen activator inhibitor 1


pregnancy-associated plasma protein


prostaglandin dehydrogenase


prostaglandin E2


placental growth factor


pregnancy protein 13


peroxisome proliferator activation receptor gamma


placental site nodule


placental site trophoblastic tumor




soluble endoglin


soluble vascular endothelial growth factor-receptor type 1


transforming growth factor beta


tumor necrosis factor-alpha


vascular endothelial growth factor


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of PathologyUniversity Hospitals, Case Medical CenterClevelandUSA

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