Placental expression of Annexin A5, Apelin, and Caspase-3 in gestational hypothyroidism: A clinicopathological study

Gestational hypothyroidism causes derangements in placental development. The novel markers, annexin A5 (ANXA5) and apelin play significant roles in placental health and disease. Caspase-3 is a pro-apoptotic protein which also modulates placental homeostasis.

The objectives of the current study were to compare gross, histopathological findings and immunohistochemical expression of ANXA5, apelin, and caspase-3 of hypothyroid placentae with those of matched controls. These findings were also correlated with clinical features of the cases. The aim was also to explore the interconnection between the three markers, ANXA5, apelin and caspase-3.

A prospective, observational study was undertaken for a period of one year. Placentae of gestational hypothyroidism were collected along with their matched controls. The sample size was 56. The gross and microscopic features, as well as immunohistochemical expression of ANXA5, apelin, and caspase-3 in hypothyroid placentae were noted.

Hypothyroid placentae showed significant histopathological changes, including fibrinoid necrosis, stromal fibrosis, syncytial knots, and cytotrophoblastic proliferation. Compared with controls, they exhibited significantly lower ANXA5 and apelin expression and higher caspase-3 expression, suggesting interrelated regulatory mechanisms.

This study explores the patterns of expression of ANXA5, apelin and caspase-3 in placentae of cases of gestational hypothyroidism. The inter-relationship of the markers with one another and that of the markers with clinical features, contribute to better understanding of the pathophysiology of gestational hypothyroidism.