Acute atherosis in vacuum suction biopsies of decidua basalis: An evidence based research definition

Abstract

Our evidence based criterion for decidua basalis AA diagnosis in vacuum suction biopsies may not apply to myometrial or decidua parietalis arteries. In decidual basalis samples it should facilitate comparisons between research studies, to improve pathophysiological understanding of AA and preeclampsia.

Spiral artery remodeling and maternal cardiovascular risk

“…However, the relation between placental bed pathology, the presence or absence of underlying cardiovascular risk factors, and the risk of incident CVD events later in life is not clear. Further, it should be noted that the presence of acute atherosis lesions in the decidua is estimated to occur in about 11% uncomplicated pregnancies [40]. In the study by Harsem et al [14] no associations were found between decidual atherosis lesions and antepartum lipid levels in N ¼ 17 preeclampsia patients.…”

Auto-antibodies against the angiotensin II type I receptor in women with uteroplacental acute atherosis and preeclampsia at delivery and several years postpartum

“…Important strengths of our study are the clinically well-defined study population, the constant method of biological sample collection and storage, as well as targeted decidua basalis tissue sampling and thoroughly defined criteria for decidua basalis acute atherosis (Alnaes-Katjavivi et al, 2016). Another advantage is the sophisticated bioassay approach to identify AT1-AA, based on spontaneously beating neonatal rat cardiomyocytes exposed to serum from the pregnant women, where the exact binding site of the AT1-AA to the AT1R is identified.…”

“…The decidual tissue acute atherosis diagnosis of the included patients has been performed and published previously for a larger cohort (Alnaes-Katjavivi et al, 2016). In brief, vacuum suction collected and rinsed decidual tissue (endometrium of pregnancy) was formalin fixed, routinely processed and paraffin embedded and used for immunohistochemistry.…”

“…Acute atherosis is a pregnancy-specific lesion of the uteroplacental spiral artery wall, resembling early stages of atherosclerosis (Stary et al, 1994, Alnaes-Katjavivi et al, 2016. Previous studies by our group showed that uteroplacental acute atherosis occurs in 30-40% of preeclamptic women at cesarean delivery, and is not restricted to early-onset disease (Harsem et al, 2007, Alnaes-Katjavivi et al, 2016.…”

The immunophenotype of decidual macrophages in acute atherosis

“…Acute atherosis has been described in the spiral arteries of the decidua underlying the placenta, termed the decidua basalis, and in the decidua parietalis (underlying the fetal chorioamniotic membranes), as well as in myometrial tissues . Such lesions are characterized by the presence of (a) fibrinoid necrosis of the vessel wall, (b) perivascular lymphocytic infiltration, and (c) accumulation of foam cells . The foam cells detected in the decidual tissues from women with acute atherosis are described as lipid‐laden macrophages; however, other non‐foamy macrophages are detected in and around these vessels.…”