Immunohistochemical localization of podoplanin in the placentas of HIV-positive preeclamptic women

Abstract

Background/aim: Impaired lymphatic function is associated with pathological conditions. The presence of placental lymphatics is stillunder debate. This study evaluates the placental podoplanin expression in normotensive and preeclamptic women with and withoutHIV.Materials and methods: Normotensive (n = 60) and preeclamptic (n = 120) pregnant women were stratified into early and lateonset preeclampsia and further divided by HIV status. Immunostaining was performed using the podoplanin antibody prior to themorphometric image analysis.Results: Podoplanin was immunolocalized in a reticular-like stroma complex within the exchange and conducting villi. Theimmunoexpression of podoplanin was significantly upregulated in the exchange villi (P = 0.001) irrespective of the pregnancy type andHIV status. Based on pregnancy type, podoplanin was downregulated in early onset preeclampsia (15.33 ± 4.27%) compared to lateonset preeclampsia in the exchange villi (17.85 ± 4.74%; P = 0.04). Podoplanin was upregulated in HIV+ vs. HIV- cases regardless ofpregnancy and villi type. Irrespective of pregnancy type, podoplanin immunoexpression within exchange villi was different (P = 0.008)between the HIV+ and HIV- groups.Conclusion: Placental fluid homeostasis is maintained by a podoplanin reticular-like complex within conducting and exchange villi,being upregulated in HIV-positive pregnancies.