Immunohistochemical study of matrix metalloproteinases 2 and 9 in the placenta of spontaneous miscarriage

Abstract

Miscarriage is the termination of pregnancy by spontaneous expulsion of embryo/fetus before 25 weeks of gestation or when the fetus weighs less than 500 grams. It is the most common pregnancy problem, impacting around 10% to 15% of all pregnancies. Matrix metalloproteinase 2 and 9 (MMP-2 and MMP-9) play a crucial role in embryo implantation and placentation; spontaneous abortion has been observed when there is abnormal expression of MMP-2 and MMP-9 levels. This research aims to evaluate the expression of MMP-2 and MMP-9 in the placenta of women with spontaneous miscarriage. The placental specimens were collected from 30 women who had delivered normally as a control group, 30 women who had miscarried in the first trimester, and 30 women who had miscarried in the second trimester. The specimens included the decidua basalis and trophoblast. The expression patterns of MMP-2 and MMP-9 were examined using the immunohistochemical study. Antibodies were used against MMP2 and MMP9. The results revealed a strong expression of MMP-2 and MMP-9 in the placenta of normally delivered women; 18 and 20 cases of first and second-trimester miscarriage showed weak expression of MMP-2, while 12 and 10 cases of both trimesters revealed moderate expression. MMP-9 showed weak expression in decidua and trophoblastic tissue of 26 and 24 cases of the first and second trimester, 4 and 6 specimens reported moderate expression in the first and second-trimester miscarriage, and significant differences were detected between the study groups (p-value <0.01). We conclude that MMP-2 and MMP-9 immunopositivity could indicate uncontrolled invasion of trophoblasts, leading to their destructive invasion and contributing to spontaneous miscarriage pathogenesis.

Keywords

• Immunohistochemistry
• Miscarriage
• MMP2
• MMP9
• Placenta

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