Quantification of the glycocalyx in the study of pre-eclampsia

Abstract

Introduction: Pre-eclampsia is a multisystem disorder of pregnancy characterised by widespread endothelial dysfunction. The glycocalyx is present at the luminal surface of endothelial cells and at the maternal-fetal interface of the placenta. It has important roles in maintaining normal endothelial function and may be shed in disease, including pre-eclampsia. The aim of this project was to develop reliable methodologies of imaging and quantifying the glycocalyx of the maternal endothelium and placenta, to test if glycocalyx shedding is a feature of pre-eclampsia.
Methods: A prospective cohort study enrolled pregnant women with pre-eclampsia and normotensive controls. The maternal sublingual glycocalyx was measured using sidestream darkfield (SDF) imaging with GlycoCheckTM. Placental tissue was collected following delivery and processed for both light and electron microscopy. Methodologies were developed to image and quantify the glycocalyx at the maternal-fetal interface using confocal and transmission electron microscopy (TEM).
Results: An increase in the sublingual perfused boundary region (PBR) was detected using GlycoCheckTM in women with early-onset pre-eclampsia (A trend was observed towards a reduction in the depth of the glycocalyx of the syncytiotrophoblast in women with early-onset pre-eclampsia, but this did not reach statistical significance. The trend could not be replicated in an independent cohort.
Conclusion: Disruption of the maternal endothelial glycocalyx is a feature of early-onset pre-eclampsia, but not late onset disease. Further work is required to determine the role the placental glycocalyx in pre-eclampsia.

Date of Award	24 Jan 2023
Original language	English
Awarding Institution	University of Bristol
Supervisor	Victoria L Bills (Supervisor), Simon C Satchell (Supervisor) & Rebecca Foster (Supervisor)