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Cytotrophoblast induction of arterial apoptosis and lymphangiogenesis in an in vivo model of human placentation
Kristy Red-Horse, Jose Rivera, Andrea Schanz, Yan Zhou, Virginia Winn, Mirhan Kapidzic, Emin Maltepe, Kelly Okazaki, Ronit Kochman, Kim Chi Vo, Linda Giudice, Adrian Erlebacher, Joseph M. McCune, Cheryl A. Stoddart, Susan J. Fisher
Kristy Red-Horse, Jose Rivera, Andrea Schanz, Yan Zhou, Virginia Winn, Mirhan Kapidzic, Emin Maltepe, Kelly Okazaki, Ronit Kochman, Kim Chi Vo, Linda Giudice, Adrian Erlebacher, Joseph M. McCune, Cheryl A. Stoddart, Susan J. Fisher
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Research Article Angiogenesis

Cytotrophoblast induction of arterial apoptosis and lymphangiogenesis in an in vivo model of human placentation

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Abstract

We studied the vascular effects of invasive human cytotrophoblasts in vivo by transplanting placental villi to the fifth mammary fat pads or beneath the kidney capsules of Scid mice. Over 3 weeks, robust cytotrophoblast invasion was observed in both locations. The architecture of the mammary fat pad allowed for detailed analysis of the cells’ interactions with resident murine blood vessels, which revealed specific induction of apoptosis in the endothelial cells and smooth muscle walls of the arterioles. This finding, and confirmation of the results in an in vitro coculture model, suggests that a parallel process is important for enabling cytotrophoblast endovascular invasion during human pregnancy. Cytotrophoblast invasion of the kidney parenchyma was accompanied by a robust lymphangiogenic response, while in vitro, the cells stimulated lymphatic endothelial cell migration via the actions of VEGF family members, FGF, and TNF-α. Immunolocalization analyses revealed that human pregnancy is associated with lymphangiogenesis in the decidua since lymphatic vessels were not a prominent feature of the nonpregnant endometrium. Thus, the placenta triggers the development of a decidual lymphatic circulation, which we theorize plays an important role in maintaining fluid balance during pregnancy, with possible implications for maternal-fetal immune cell trafficking.

Authors

Kristy Red-Horse, Jose Rivera, Andrea Schanz, Yan Zhou, Virginia Winn, Mirhan Kapidzic, Emin Maltepe, Kelly Okazaki, Ronit Kochman, Kim Chi Vo, Linda Giudice, Adrian Erlebacher, Joseph M. McCune, Cheryl A. Stoddart, Susan J. Fisher

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Figure 5

Kidney capsule implantation as an in vivo model of cytotrophoblast invasion.

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Kidney capsule implantation as an in vivo model of cytotrophoblast invas...
Placental explants were surgically placed under the kidney capsules of Scid mice and maintained for 1 (A, C, D, and F–H) or 3 weeks (B, E, and I) before histological analyses. (A) Villous cores (arrows) mark the original implantation sites. One week after implantation, cytotrophoblasts invaded murine renal tissue. (B) After 3 weeks the amount of cytotrophoblast-occupied renal parenchyma increased dramatically, extending well into the cortex, with select clusters migrating even deeper. Many kidney tubules within remained intact (arrow). (C) CD31 staining revealed, within areas of cytotrophoblast invasion, vascular networks (arrow) with very different morphology from resident renal vessels (compare inset with F). (D and E) Higher-magnification images of A and B show that the migration route of invasive cytotrophoblasts was restricted to the peritubular spaces. (F) CD31 and cytokeratin double staining revealed that cells were closely associated with blood vessels coursing through these areas. (G) Cells also breached these vessels, as demonstrated by platelet deposition (red), which occurred only in areas of cytotrophoblast invasion. (H) Cytotrophoblast expression of stage-specific antigens mimicked the pattern observed during human uterine invasion. (I) Nuclear volume increased, indicative of chromosome amplification associated with cytotrophoblast invasion (25), as illustrated by the relatively small nuclear diameter of progenitor cells (arrow; left inset) compared with that of invasive cells (arrowheads; right inset). Scale bars: 500 μm (A–C); 20 μm (C, inset); 50 μm (D–I); 5 μm (I, insets).

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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