Distribution of Furin, TNF-alpha, and TGF-beta 2 in the Endometrium of Missed Abortion and Voluntary First Trimester Termination Cases

Abstract

OBJECTIVE: To identify the role of furin, TNF-alpha, and TGF-beta 2 in human missed abortion pathogenesis. STUDY DESIGN: Decidual materials were collected from patients diagnosed with a missed abortion (n=10) (missed abortion group) and from legal voluntary termination cases at <10 gestational weeks (n=10) (normal pregnancy group). Tissue samples were collected from each group by dilation and curettage under mask anesthesia. For all tissue samples, furin, TNF-alpha, and TGF-beta 2 primary antibodies were performed by immunohistochemical staining. The number of stained cells was evaluated by using the H-score technique. RESULTS: In immunohistochemical examination, the immunoreactivities of furin, TNF-alpha, and TGF-beta 2 were found to be higher in syncytiotrophoblastic cells in the missed abortion group than in the normal pregnancy group (p < 0.005). Additionally, high immunoreactivity of TNF-alpha and TGF-beta 2 molecules was established only in cytotrophoblastic cells of missed abortions (p <0.005) in examination at decidual cells of the missed abortion group; furin immunoreactivities were detected higher in the missed abortion group than in the control group, but TNF-alpha and TGF-beta 2 immunoreactivity were increased in number in the normal pregnancy group (p < 0.005). CONCLUSION: It is considered that high levels of furin and the 2 furin-related proteins (TNF-alpha and TGF-beta 2), which play important roles in proliferation, invasion, migration, differentiation, and survival of cells, may be the reason of proceeding decidualization, placentation, and prevention from abortion, in spite of terminating the fetal life.