Expression of Toll-like Receptor TLR-2, TLR-3, TLR-4 and TLR-9 Is Increased in Placentas from Patients with Preeclampsia

Background and Aims. Few studies have examined the presence of Toll-like receptors (TLRs) in term placentas from women with preeclampsia, such, have focused on TLR-4 and TLR-2 analysis. Whereas an increase in TLR-4 immunostaining has been observed in preeclampsia, it is even higher in placentas with chorioamnionitis compared with normal pregnancy. Expression of TLR-2 has not been associated with preeclampsia. The relationship of TLR-3 and TLR-9, which may recognize dsRNA or DNA, either derived either from microorganisms or from apoptotic cells and thus may be involved with this pathology, has not been studied in term placentas. We undertook this study to determine if there are changes in the expression and localization of TLR-2, TLR-4, TLR-3 and TLR-9 in preeclamptic term placentas as compared with normal placentas. Methods. A prospective, cross-sectional and comparative study was done in a group of ten patients with 38-40 gestation weeks, both in preeclamptic and control cases. Immunofluorescence detection of TLRs was performed in samples of placenta and analyzed by confocal microscopy. Results. It was observed that TLR-2, TLR-3, TLR-4 and TLR-9 were expressed both in normal and preeclamptic placentas, in the trophoblast, at the vascular endothelium (where TLR-2 and TLR-9 staining was pronounced), and at placental villous stroma, although increased expression was detected in preeclampsia. In addition, co-localization of TLR-2 and TLR-4 as well as of TLR-3 and TL9 was found in the trophoblast. Conclusions. TLR-2, -3, -4 and -9 expressions are increased in preeclamptic placentas. However, more studies are required to determine the role of TLRs in pregnancy immunology and to establish its relationship with preeclampsia. (C) 2011 IMSS. Published by Elsevier Inc.