Trophoblast damage with acute and chronic intervillositis: disruption of the placental barrier by severe acute respiratory syndrome coronavirus 2.
Trophoblast damage with acute and chronic intervillositis: disruption of the placental barrier by severe acute respiratory syndrome coronavirus 2.
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急性和慢性绒毛间炎引起的滋养细胞损伤：严重急性呼吸综合征冠状病毒对胎盘屏障的破坏
DOI：
10.1016/j.humpath.2020.12.004
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发表时间：
2021-03
期刊：
影响因子：
3.3
通讯作者：
Uhlemann AC
中科院分区：
文献类型：
--
作者：
Debelenko L;Katsyv I;Chong AM;Peruyero L;Szabolcs M;Uhlemann AC
在胎盘中发现了严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）；然而，关于胎盘感染的患病率和相关组织病理学的数据是有限的。为了确定SARS-CoV-2感染的频率和特征，我们对分娩时感染的75例胎盘病例和75例未感染的对照组进行了临床病理分析。采用抗sars - cov -2免疫组化和/或原位杂交技术研究胎盘样本。电镜和定量反转录聚合酶链反应（qRT-PCR）证实阳性结果。在分娩过程中，只有一名妇女出现了2019年冠状病毒病的症状，六名妇女报告了以前的症状，68名妇女无症状。根据鼻咽拭子PCR结果，所有新生儿的SARS-CoV-2检测均为阴性。75例sars - cov -2阳性妇女中有29例，75例sars - cov -2阴性妇女中有8例的产科史无显著差异。75例感染者中有12例胎盘检查正常，75例未感染者中有3例胎盘检查正常。在其余病例中，胎盘病理与产科合并症相关，在sars - cov -2阳性和sars - cov -2阴性妇女之间无显著差异。在一名感染但无症状的产妇的一个胎盘中发现了SARS-CoV-2。病毒染色主要局限于合胞滋养细胞（STB），表现出明显的损伤，伴绒毛周围纤维蛋白沉积和混合性绒毛间炎。根据qRT-PCR，与绒毛实质相比，在附着的脐带中检测到病毒滴度显著降低。在感染妇女的胎盘中很少发现SARS-CoV-2。病毒累及胎盘的特点是STB损伤破坏胎盘屏障，可在无垂直传播证据的无症状母亲中看到。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was demonstrated in the placenta; however, the data on the prevalence of placental infection and associated histopathology are limited. To identify the frequency and features of SARS-CoV-2 involvement, we performed a clinicopathologic analysis of 75 placental cases from women infected at the time of delivery and 75 uninfected controls. Placental samples were studied with anti–SARS-CoV-2 immunohistochemistry and/or in situ hybridization. Positive results were confirmed by electron microscopy and quantitative reverse-transcription polymerase chain reaction (qRT-PCR). During delivery, only one woman had symptoms of coronavirus disease 2019, six women reported previous symptoms, and 68 women were asymptomatic. All neonates tested negative for SARS-CoV-2 as per nasopharyngeal swab PCR results. Obstetric histories were unremarkable in 29 of 75 SARS-CoV-2–positive and 8 of 75 SARS-CoV-2–negative women. Placental examination was normal in 12 of 75 infected and 3 of 75 uninfected subjects, respectively. In the remaining cases, placental pathology correlated with obstetric comorbidities without significant differences between SARS-CoV-2–positive and SARS-CoV-2–negative women. SARS-CoV-2 was identified in one placenta of an infected, but asymptomatic, parturient. Viral staining was predominantly localized to the syncytiotrophoblast (STB) which demonstrated marked damage accompanied by perivillous fibrin deposition and mixed intervillositis. A significant decrease of viral titers was detected in the attached umbilical cord compared with the villous parenchyma as per qRT-PCR. SARS-CoV-2 is seldom identified in placentas of infected women. Placental involvement by the virus is characterized by STB damage disrupting the placental barrier and can be seen in asymptomatic mothers without evidence of vertical transmission.
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影响因子：
4.6
作者：
Schwartz, David A.;Morotti, Denise;Patane, Luisa
通讯作者：
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影响因子：
3.4
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Gencay, M;Puolakkainen, M;Koskiniemi, ML
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影响因子：
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作者：
DOSS, BJ;GREENE, MF;GENEST, DR
通讯作者：
GENEST, DR