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Endocrine Placenta

Chapter

Abstract

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.

Keywords

Gestational trophoblastic disease Hormones Invasion Labor Placenta Transport Trophoblast 

Abbreviations

ADAM

a disintegrin and metalloproteinase

ANG-2

angiopoietin 2

AT-1

angiotensin receptor, type 1

cAMP

cyclic adenosine monophosphate

ChorioCA

choriocarcinoma

CEACAM-1

carcinoembryonic antigen-like cellular adhesion molecule

CRH

corticotropin-releasing hormone

CRH-BP

corticotropin-releasing hormone binding protein

cT

cytotrophoblast

DHEA

dehydroepiandrosterone

E2

estradiol

E3

estriol

EpT

epithelioid trophoblast

ETT

epithelioid trophoblastic tumor

EvT

endovascular trophoblast

hCG

human chorionic gonadotropin

hGH-V

human growth hormone-variant

hPL

human placental lactogen

HIF-1

hypoxia-induced factor 1

HSD

11-beta hydroxysteroid dehydrogenase

IGF

insulin-like growth factor

IGF-II/MBP receptor

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

IGF-BP

insulin-like growth factor binding protein

iT

intermediate trophoblast

LDL

low-density lipoprotein

P4

progesterone

PAI-1

plasminogen activator inhibitor 1

PAPP-A

pregnancy-associated plasma protein

PGDH

prostaglandin dehydrogenase

PGE2

prostaglandin E2

PlGF

placental growth factor

PP13

pregnancy protein 13

PPAR-γ

peroxisome proliferator activation receptor gamma

PSN

placental site nodule

PSTT

placental site trophoblastic tumor

ScT

syncytiotrophoblast

sENG

soluble endoglin

sflt-1

soluble vascular endothelial growth factor-receptor type 1

TGF-β

transforming growth factor beta

TNF-α

tumor necrosis factor-alpha

VEGF

vascular endothelial growth factor

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

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

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