Journal Article

Molecular Insights into the Thrombotic and Microvascular Injury in Placental Endothelium of Women with Mild or Severe COVID-19

Helguera-Repetto, Cecilia, Espino y Sosa, Salvador, Torres-Torres, Johnatan, León-Juárez, Moisés, Estrada-Gutierrez, Guadalupe, Vega-Torreblanca, Sara, González-Mariscal, Lorenza, Cardona-Pérez, Arturo, Flores-Pliego, Arturo, González, Rosa O., Borboa-Olivares, Héctor, Miranda, Jael, Espejel-Nuñez, Aurora, Villegas-Mota, Isabel, Valdespino-Vázquez, Yolotzin, Juárez-Reyes, Ángeles, Rizo-Pica, Thelma, Mateu-Rogell, Paloma, Ramírez-Santes, Victor

2021

Overview

Clinical manifestations of coronavirus disease 2019 (COVID-19) in pregnant women are diverse, and little is known of the impact of the disease on placental physiology. Severe acute respiratory syndrome coronavirus (SARS-CoV-2) has been detected in the human placenta, and its binding receptor ACE2 is present in a variety of placental cells, including endothelium. Here, we analyze the impact of COVID-19 in placental endothelium, studying by immunofluorescence the expression of von Willebrand factor (vWf), claudin-5, and vascular endothelial (VE) cadherin in the decidua and chorionic villi of placentas from women with mild and severe COVID-19 in comparison to healthy controls. Our results indicate that: (1) vWf expression increases in the endothelium of decidua and chorionic villi of placentas derived from women with COVID-19, being higher in severe cases; (2) Claudin-5 and VE-cadherin expression decrease in the decidua and chorionic villus of placentas from women with severe COVID-19 but not in those with mild disease. Placental histological analysis reveals thrombosis, infarcts, and vascular wall remodeling, confirming the deleterious effect of COVID-19 on placental vessels. Together, these results suggest that placentas from women with COVID-19 have a condition of leaky endothelium and thrombosis, which is sensitive to disease severity.

• Publisher: MDPI AG,MDPI
• Subject: ACE2 / Adult / Angiotensin-converting enzyme 2 / Antigens / Antigens, CD - analysis / Apoptosis / Asymptomatic / Blood platelets / Brain research / Cadherins / Cadherins - analysis / Cell adhesion & migration / Cesarean section / claudin-5 / Claudin-5 - analysis / Coronaviridae / Coronaviruses / COVID-19 / COVID-19 - complications / COVID-19 - pathology / COVID-19 - virology / Cytokines / Decidua / Disease transmission / Endothelium / Endothelium - blood supply / Endothelium - pathology / Endothelium - virology / Enzymes / Female / Humans / Immunofluorescence / Infant, Newborn / Infections / Medical research / Microvasculature / Microvessels - pathology / Microvessels - virology / Miscarriage / Pandemics / Permeability / Placenta / Placenta - blood supply / Placenta - pathology / Pregnancy / Pregnancy Complications, Cardiovascular - etiology / Pregnancy Complications, Cardiovascular - pathology / Pregnancy Complications, Cardiovascular - virology / Pregnancy Complications, Infectious - etiology / Pregnancy Complications, Infectious - pathology / Pregnancy Complications, Infectious - virology / Proteins / Respiratory diseases / SARS-CoV-2 - isolation & purification / Severe acute respiratory syndrome coronavirus 2 / Thrombosis / Thrombosis - etiology / Thrombosis - pathology / Thrombosis - virology / VE-cadherin / Villus / Von Willebrand factor / von Willebrand Factor - analysis / Womens health / Young Adult