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  • Küçük Resim
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    The changes in Hoffbauer and syncytiotrophoblast cells in serious preeclampsia complicated with hellp syndrome (Ultrastructural and immunohistochemical study)
    (INESEG Yayıncılık, 2022) Nergiz, Yusuf; Nergiz, Şebnem; Aşır, Fırat; Deveci, Engin; Sak, Erdal; Evsen, Sıddık; Tunik, Selçuk; Şeker, Uğur
    HELLP syndrome is a syndrome characterized by hemolytic anemia, increased liver enzymes, and thrombopenia and can be seen in 1% of all pregnancies, 10-20% of pregnancies with pain, preeclampsia, and eclampsia. HELLP syndrome usually develops in the third trimester and its pathogenesis is not clear. Human placental villus stroma contains macrophages called Hoffbauer cells (HC), which are thought to be involved in many processes. HC is also called placental macrophage and has a role in many placental events. This study aimed to evaluate the immunohistochemistry and ultrastructural of syncytiotrophoblast and Hoffbauer cells in the placental villi of HELLP syndrome patients. In our study, placental tissues obtained from human normal and HELLP syndrome pregnancies were prepared for light and transmission electron microscopy (TEM) studies. Immunohistochemistry techniques were applied to placenta sections. HC localizations were determined with CD68 (Hoffbauer cell marker). Fine structure properties of HC and syncytiotrophoblasts were examined by TEM. When the HELLP group fetal placental sections were examined under the light microscope, intracytoplasmic edema in syncytiotrophoblast, degenerative vacuoles, and degenerative findings on cell surface membranes were observed. Moreover, villous edema was remarkable. The increase in the number of Hoffbauer cells per villus in the HELLP group was statistically significant (p<0.00). Compared with the control group, there was a significant increase in the number of Hoffbauer cells and syncytiotrophoblast in HELLP group, and also degenerative changes were observed in the ultrastructural structure of these cells.
  • Küçük Resim
    Öğe
    Severe preeclampsia complicated by HELLP syndrome alters the structure of Hofbauer and syncytiotrophoblast cells: ultrastructural and immunohistochemical study
    (Sciendo, 2023) Nergiz, Yusuf; Deveci, Engin; Sak, Erdal; Evsen, Sıddık; Tunik, Selçuk; Nergiz, Şebnem; Aşır, Fırat; Şeker, Uğur
    Background: Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is generally considered to be a variant or complication of preeclampsia. It is a life-threatening obstetric complication. Objectives: To evaluate the immunohistochemistry and ultrastructural of syncytiotrophoblastand Hoffbauer cells in placental villi of patients with HELLP syndrome. Methods: Two groups of patients with a total of 50 full-term human placentas (n = 25 in each group) were assigned as the control (normotensive) and HELLP syndrome. Placental tissue samples were fixed in 10% neutral formalin and paraffin-embedding protocol was performed. We prepared 5 μm sections for histological and immunohistochemical staining. Sections were immunostained with Hoffbauer cell marker CD68. For transmission electron microscopy (TEM), placental tissue samples were fixed in 2.5% buffered glutaraldehyde and then, in 1% osmium tetroxide for routine ultrastructural examinations. Results: When the HELLP group fetal placental sections were examined, intracytoplasmic edema in syncytiotrophoblast, degenerative vacuoles, and degenerative findings on cell surface membranes were observed. Moreover, villous edema was remarkable. The number of CD68-positive Hoffbauer cells per villus control group sections was 0.23 ± 0.02 and the number of CD68-positive cells per villus in HELLP group placenta sections was 0.83 ± 0.12. The increase in the number of Hoffbauer cells per villus in the HELLP group was significant (P < 0.001). Compared with the control group, there was a significant increase in the number of Hoffbauer cells and syncytiotrophoblasts in the HELLP group, and degenerative changes were also observed in the ultrastructure of these cells. Conclusions: Pathology of the HELLP syndrome is in relation to CD68-positive placental macrophages.