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Human Reproduction, Vol. 14, No. suppl_2, pp. 90-98, 1999
© 1999 European Society of Human Reproduction and Embryology

Role of the IGF system in trophoblast invasion and pre-eclampsia

J.C. Irwin1, L.-F. Suen, N.A. Martina, S.P. Mark and L.C. Giudice

Division of Reproductive Endocrinology and Infertility, Department of Gynecology & Obstetrics, Stanford University Medical Center Stanford, CA 94305–5317, USA

Correspondence: 1To whom correspondence should be addressed

Insulin-like growth factor-II (IGF-II) and IGF binding protein-1 (IGFBP-1) appear to play an important role in paracrine interactions at the maternal–fetal interface in human pregnancy. Patterns of expression of IGF-II and IGFBP-1 at the decidual–trophoblast interface suggest paracrine interactions occur between the IGFII-expressing invading cytotrophoblast and maternal decidua-derived IGFBP-1. Autocrine/paracrine actions of trophoblast-derived IGFII may be important in invasion, and for both trophoblast and decidual function. The actions of IGFBP-1 in binding IGF, and as an integrin ligand, suggest it may have multiple roles in the interactions between the invading trophoblast and the maternal decidua. Abundant decidual IGFBP-1 may interact with the IGF-II-expressing, protease-secreting trophoblast to modulate invasion. In-vitro studies of trophoblast–decidual cell interactions in invasion, and clinical observations in a gestational disorder with shallow placental invasion such as preeclampsia, have provided new insights into the possible role(s) of IGFBP-1 in trophoblast invasion. The precise mechanisms underlying IGF and IGFBP-1 action at the decidual–trophoblast interface remain to be elucidated. The potential predictive value of serum IGFBP-1 concentrations in pre-eclampsia also remains to be established.

Key words: decidua/IGFBP-1/maternal–fetal interface/pre-eclampsia/trophoblast invasion


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