Abstract

Preeclampsia (PE) and gestational diabetes (GD) are complications in advanced pregnancy while miscarriage for early pregnancy. However, the etiological factors are not well understood. Smoking has been associated with these complications as well as the sudden intrauterine deaths, sudden infant death, miscarriages, and still births. However, the immunolocalization of alpha 7 nicotine acetylcholine receptor (α7-nAChR) is not studied.Materials and Methods: α7-nAChR subunit expression was evaluated in 10 paraffin-embedded placental tissues after delivery and 10 tissue samples of products of conception during first trimester by immunohistochemistry. Among the placental tissues, two samples were normal placental tissue, four from PE mother, and four from GD mother. The expression of α7-nAChR was compared between the two groups in general and within the subgroups of placenta as well. Protein expression was evaluated using the nuclear labeling index (%) of villi with positive cells stained, positive cells in the decidua, and intensity of staining in the outer villous trophoblast layer.Results: The expression of α7-nAChR protein was high in all the cases of placenta and products of conception (POCs). α7-nAChR expression showed no notable differences among different cases of miscarriages irrespective of the mother’s age and gestational age at which the event occurred. However, there were some changes among the normal, PE, and GD placental groups in the linings of the blood vessels. Changes were restricted to the villi (as opposed to the decidua) lining cells, both cytotrophoblast and syncytiotrophoblast, and were specific to the α7 subunit. PE blood vessel lining was thicker and showed more expression of this receptor in endothelial cells and myofibroblasts in PE and GD groups. In POCs, the strong expression was observed in the decidua myocytes of maternal blood vessels and in syncytiotrophoblast and cytotrophoblast of chronic villi.Conclusion: Nicotine acetyl choline receptors are found to be expressed highly in the placental tissues and in products of conception. They may be associated with the sudden perinatal deaths and miscarriages or complications of pregnancy.

Highlights

  • The prevalence of preeclampsia (PE) and gestational diabetes (GD) during pregnancy is 2–8% (Umesawa and Kobashi, 2017), respectively

  • Placentas were collected within the first hour of delivery

  • The retained products of conception (POCs) tissue samples were collected from patients having miscarriages during the first trimester

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Summary

Introduction

The prevalence of preeclampsia (PE) and gestational diabetes (GD) during pregnancy is 2–8% (Umesawa and Kobashi, 2017), respectively. The hazardous effects of exposure to tobacco smoking, whether active or passive, during pregnancy include placenta previa (Shobeiri and Jenabi, 2017), placental abruption (Ananth et al, 2016), ectopic pregnancy, early membrane rupture, low birth weight (Bar-Zeev and Solt, 2018), premature birth, sudden perinatal deaths, and stillbirths (Lavezzi et al, 2017; Anderson et al, 2019). We have highlighted these aspects in previous studies as well (Lavezzi et al, 2010, 2011, 2020; Mehboob, 2017; Mehboob et al, 2017; Muhammad et al, 2018). Nicotine can mimic the effect of ACh and incorrectly signal the cholinergic system to activate when there is no requirement (Robbins, 2016)

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