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Trisomy 21 is Associated with Caspase-2 Upregulation in Cytotrophoblasts at the Maternal-Fetal Interface

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Abstract

Impaired placentation is implicated in poor perinatal outcomes associated with Trisomy 21. Earlier studies revealed abnormal cytotrophoblast differentiation along the invasive pathway as a contributing mechanism. To further elucidate the causes, we evaluated Caspase-2 expression at the protein level (immunolocalization and immunoblot) in samples from Trisomy 21 (n = 9) and euploid (n = 4) age-matched placentas. Apoptosis was investigated via the TUNEL assay. An immunolocalization approach was used to characterize Caspase-3, Fas (CD95), and Fas ligand in the same samples. Caspase-2 was significantly overexpressed in Trisomy 21 placentas, with the highest expression in villous cores and invasive cytotrophoblasts. Immunolocalization showed that Caspase-3 had a similar expression pattern as Caspase-2. Using the TUNEL approach, we observed high variability in the number of apoptotic cells in biopsies from different regions of the same placenta and among different placentas. However, Trisomy 21 placentas had more apoptotic cells, specifically in cell columns and basal plates. Furthermore, Caspase-2 co-immunolocalized with Fas (CD95) and FasL in TUNEL-positive extravillous cytotrophoblasts, but not in villous cores. These results help explain the higher levels of apoptosis among placental cells of Trisomy 21 pregnancies in molecular terms. Specifically, the co-expression of Caspase-2 and Caspase-3 with other regulators of the apoptotic process in TUNEL-positive cells suggests these molecules may cooperate in launching the observed apoptosis. Among trophoblasts, only the invasive subpopulation showed this pattern, which could help explain the higher rates of adverse outcomes in these pregnancies. In future experiments, this relationship will be further examined at a functional level in cultured human trophoblasts.

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Acknowledgements

We thank Mr. Jason Farrell for assistance with tissue collection. We are also grateful to members of the Fisher Lab for helpful discussion, to Drs. Tippi MacKenzie and Anna Bakardjiev for reviewing a draft of this paper and Elizabeth Seckel for copy editing.

Funding

Funding provided by the Clinical and Translational Research Program at the University of California, San Francisco, supported in part by the PROF-PATH Program, which is funded by the National Institute on Minority Health and Health Disparities (NIMHD) Award R25MD006832. Dr. Katherine Bianco was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)/National Institute of Health (NIH) Clinical Investigator Award K08HD069518-01. Placental tissue collection supported in part by Eunice Kennedy Shriver NICHD/NIH through a cooperative agreement P50 HD055764, as part of the Specialized Cooperative Centers Program in Reproduction and Infertility Research.

This content is solely the responsibility of the authors and does not necessarily represent the official views of NIMHD, NICHD or NIH.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Yale University, New Haven, CT, USA

    Daisy Leon-Martinez

  2. Center for Reproductive Sciences, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, 94143, USA

    Joshua F. Robinson, Tamara Zdravkovic, Olga Genbacev, Matthew Gormley, Michael Mcmaster & Susan J. Fisher

  3. The Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, 94143, USA

    Joshua F. Robinson, Tamara Zdravkovic, Olga Genbacev, Matthew Gormley, Michael Mcmaster & Susan J. Fisher

  4. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Stanford University, 300 Pasteur Dr. HH333 MC 5317, Stanford, CA, 94305, USA

    Katherine Bianco

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  1. Daisy Leon-Martinez
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Correspondence to Katherine Bianco.

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The authors declare that they have no conflict of interest. Susan J. Fisher was a consultant for Verinata Health, Inc an Illumina Company. Katherine Bianco was a consultant for SeraCare Life Science Inc.

Electronic supplementary material

Supplemental Table 1

(DOCX 12 kb).

Supplemental Fig. 1.

CASP2 colocalizes with markers of apoptosis in CTBs in the cell columns and basal plate, but not in the villous core. Placental biopsies from the MFI were probed with antibodies for additional markers of apoptosis – Fas (CD95) and Fas Ligand (FasL) (A–P). Similar to TUNEL assay findings (Fig. 3), Fas (CD95) expression was greatest in invasive CTBs in the basal plate, as seen by co-localization of cytokeratin 7 and Fas (CD95) (A–H). Fas (CD95) and FasL co-localization was also limited to the basal plate (I–P). This suggests that apoptosis is greatest at the MFI. Arrows indicate direction of CTB invasion. Abbreviations: vc villous core, bp basal plate, fv floating villi. Scale bar = 100 μm (JPG 793 kb).

Supplemental Fig. 2

CASP2 expression in an euploid placenta as compared to a T21 placenta. CASP2 expression is minimal in the euploidy invasive pathway. In the case of T21, CASP2 expression is upregulated in the villous core towards the basal plate. Arrows indicate direction of CTB invasion. Abbreviations: vc villous core, bp basal plate, Scale bar = 100 μm (JPG 433 kb).

Supplemental Fig. 3

Hematoxylin and eosin (H&E) staining sections of euploid placentas as compared to T21 placentas. Panels A–D are euploid placentas at 15 and 20 weeks. Panels E through H are placentas affected with T21 at 17 and 22 weeks. Magnification at 10× and 20× (JPG 748 kb).

Supplemental Fig. 4

Overexpression of CASP2 was observed in T21 placentas. Five T21 placentas are presented between 13.3 and 22.5 weeks’ gestation. Degree of DAPI staining in blue, cytokeratin 7 in red, and CASP2 in green. Abbreviations: vc villous core, bp basal plate, fv floating villi (JPG 524 kb).

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Leon-Martinez, D., Robinson, J.F., Zdravkovic, T. et al. Trisomy 21 is Associated with Caspase-2 Upregulation in Cytotrophoblasts at the Maternal-Fetal Interface. Reprod. Sci. 27, 100–109 (2020). https://doi.org/10.1007/s43032-019-00002-x

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