Placental NLRP3 expression across placenta accreta spectrum, placenta previa, and other non-PAS placental pathologies: an immunohistochemical study

Dinçer Sümer; Hitay Cemre Metindoğan; Firdevs Şahin Duran; Ahmet Arif Filiz; Özgür Volkan Akbulut; Büşra Seçilir; Furkan Akın; Zehra Yılmaz; Şevki Çelen; Ali Çağlar

Placental NLRP3 expression across placenta accreta spectrum, placenta previa, and other non-PAS placental pathologies: an immunohistochemical study

Abstract

Aims: Placenta accreta spectrum (PAS) is characterized by abnormal trophoblast invasion and is associated with substantial maternal morbidity. This study aimed to evaluate placental NLRP3 protein expression across PAS, placenta previa, and other non-PAS placental pathologies. Methods: This retrospective study included 52 placental specimens: 26 PAS cases, 11 placenta previa cases, and 15 other non-PAS placental pathologies. NLRP3 expression was assessed immunohistochemically using a semi-quantitative scoring system. Logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate the association of NLRP3 with PAS. Results: NLRP3 staining scores differed significantly across the three study groups (p=0.036). However, none of the pairwise comparisons remained statistically significant after Bonferroni correction, although PAS showed a trend toward higher NLRP3 expression than other non-PAS placental pathologies before correction (uncorrected p=0.018), these findings should be considered exploratory. In univariable logistic regression, higher NLRP3 expression was associated with PAS (OR 1.318, 95% CI 1.041–1.669, p=0.022). After adjustment, the number of previous cesarean deliveries remained independently associated with PAS (aOR 8.621, 95% CI 2.325–31.959, p=0.001), whereas NLRP3 expression showed a borderline independent association (aOR 1.480, 95% CI 0.988–2.216, p=0.057). ROC analysis demonstrated modest discriminative performance in this cohort (AUC 0.685, 95% CI 0.540–0.830, p=0.022). Conclusion: Placental NLRP3 expression showed a trend toward higher expression in PAS but pairwise differences did not remain statistically significant after Bonferroni correction. Accordingly, these findings should be considered exploratory and hypothesis-generating. Although NLRP3 may be involved in inflammatory pathways related to abnormal placentation, its diagnostic performance was modest and its independent predictive value appeared limited after adjustment for established clinical risk factors.

Keywords

Supporting Institution

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethical Statement

Ethics approval and consent to participate This retrospective study was carried out in compliance with the Helsinki Declaration. Ethical approval was obtained from the ethics committee of the Etlik City Hospital, Ankara, Türkiye (Ankara Etlik City Hospital Ethics Committee Approval number AEŞH-BADEK2-2025-004). Patients were contacted by telephone, informed about the study, and provided verbal consent for the use of their medical data.

Thanks

We sincerely thank the Editor and the Editorial Team for their time, effort, and valuable consideration of our manuscript.

References

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Details

Primary Language

English

Subjects

Obstetrics and Gynaecology

Journal Section

Research Article

Authors

Dinçer Sümer ^*
0000-0002-7034-6811
Türkiye

Hitay Cemre Metindoğan
0009-0005-3149-2006
Türkiye

Firdevs Şahin Duran
0000-0001-9244-9590
Türkiye

Ahmet Arif Filiz
0000-0002-6137-0270
Türkiye

Özgür Volkan Akbulut
0000-0002-1960-2146
Türkiye

Büşra Seçilir
0009-0002-2140-7152
Türkiye

Furkan Akın
0009-0004-4026-1974
Türkiye

Zehra Yılmaz
0000-0002-8719-1879
Türkiye

Şevki Çelen
0000-0001-7033-3474
Türkiye

Ali Çağlar
0000-0002-7022-3029
Türkiye

Publication Date

October 25, 2026

Submission Date

June 27, 2026

Acceptance Date

September 11, 2026

Published in Issue

Year 2026 Volume: 7 Number: 5

IZ

https://izlik.org/JA34KP97BL

Cite

RIS / Bibtex

APA

Sümer, D., Metindoğan, H. C., Şahin Duran, F., Filiz, A. A., Akbulut, Ö. V., Seçilir, B., Akın, F., Yılmaz, Z., Çelen, Ş., & Çağlar, A. (2026). Placental NLRP3 expression across placenta accreta spectrum, placenta previa, and other non-PAS placental pathologies: an immunohistochemical study. Journal of Medicine and Palliative Care, 7(5), 1029-1036. https://izlik.org/JA34KP97BL

AMA

1.Sümer D, Metindoğan HC, Şahin Duran F, et al. Placental NLRP3 expression across placenta accreta spectrum, placenta previa, and other non-PAS placental pathologies: an immunohistochemical study. J Med Palliat Care / JOMPAC / jompac. 2026;7(5):1029-1036. https://izlik.org/JA34KP97BL

Chicago

Sümer, Dinçer, Hitay Cemre Metindoğan, Firdevs Şahin Duran, et al. 2026. “Placental NLRP3 Expression across Placenta Accreta Spectrum, Placenta Previa, and Other Non-PAS Placental Pathologies: an Immunohistochemical Study”. Journal of Medicine and Palliative Care 7 (5): 1029-36. https://izlik.org/JA34KP97BL.

EndNote

Sümer D, Metindoğan HC, Şahin Duran F, Filiz AA, Akbulut ÖV, Seçilir B, Akın F, Yılmaz Z, Çelen Ş, Çağlar A (October 1, 2026) Placental NLRP3 expression across placenta accreta spectrum, placenta previa, and other non-PAS placental pathologies: an immunohistochemical study. Journal of Medicine and Palliative Care 7 5 1029–1036.

IEEE

[1]D. Sümer et al., “Placental NLRP3 expression across placenta accreta spectrum, placenta previa, and other non-PAS placental pathologies: an immunohistochemical study”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 5, pp. 1029–1036, Oct. 2026, [Online]. Available: https://izlik.org/JA34KP97BL

ISNAD

Sümer, Dinçer - Metindoğan, Hitay Cemre - Şahin Duran, Firdevs - Filiz, Ahmet Arif - Akbulut, Özgür Volkan - Seçilir, Büşra - Akın, Furkan - Yılmaz, Zehra - Çelen, Şevki - Çağlar, Ali. “Placental NLRP3 Expression across Placenta Accreta Spectrum, Placenta Previa, and Other Non-PAS Placental Pathologies: an Immunohistochemical Study”. Journal of Medicine and Palliative Care 7/5 (October 1, 2026): 1029-1036. https://izlik.org/JA34KP97BL.

JAMA

1.Sümer D, Metindoğan HC, Şahin Duran F, Filiz AA, Akbulut ÖV, Seçilir B, Akın F, Yılmaz Z, Çelen Ş, Çağlar A. Placental NLRP3 expression across placenta accreta spectrum, placenta previa, and other non-PAS placental pathologies: an immunohistochemical study. J Med Palliat Care / JOMPAC / jompac. 2026;7:1029–1036.

MLA

Sümer, Dinçer, et al. “Placental NLRP3 Expression across Placenta Accreta Spectrum, Placenta Previa, and Other Non-PAS Placental Pathologies: an Immunohistochemical Study”. Journal of Medicine and Palliative Care, vol. 7, no. 5, Oct. 2026, pp. 1029-36, https://izlik.org/JA34KP97BL.

Vancouver

1.Dinçer Sümer, Hitay Cemre Metindoğan, Firdevs Şahin Duran, Ahmet Arif Filiz, Özgür Volkan Akbulut, Büşra Seçilir, Furkan Akın, Zehra Yılmaz, Şevki Çelen, Ali Çağlar. Placental NLRP3 expression across placenta accreta spectrum, placenta previa, and other non-PAS placental pathologies: an immunohistochemical study. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Oct. 1;7(5):1029-36. Available from: https://izlik.org/JA34KP97BL