Cardiac ion channels associated with unexplained stillbirth - an immunohistochemical study

Susana Quesado Branco, Gauri Batra, Gemma Petts, Ainslie Hancock, Alan Kerby, Chloe Anne Brady, Alexander E P Heazell

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: Despite the use of post-mortem investigations, approximately 20% of stillbirths remain unexplained. Cardiac ion channelopathies have been identified as a cause of death in Sudden Infant Death Syndrome (SIDS) and could be associated with unexplained stillbirths. This study aimed to understand if the expression or localisation of cardiac ion channels associated with channelopathies were altered in cases of unexplained stillbirths.

METHODS: A case control study was conducted using formalin-fixed cardiac tissue from 20 cases of unexplained stillbirth and a control group of 20 cases of stillbirths from intrapartum hypoxia. 4 µm tissue sections were stained using haematoxylin and eosin, Masson's trichrome (MT) and Elastic van Gieson (EVG). Immunohistochemistry (IHC) was performed using antibodies against CACNA1G, KCNJ2, KCNQ1, KCNH2 and KCNE1. The cardiac conduction system in samples stained with MT and EVG could not be identified. Therefore, the levels of immunoperoxidase staining were quantified using QuPath software.

RESULTS: The nuclear-cytoplasmic ratio of sections stained with haematoxylin and eosin was higher for the hypoxia group (hypoxia median 0.13 vs. 0.04 unexplained, p < 0.001). CACNA1G (unexplained median 0.26 vs. hypoxia 0.30, p=0.009) and KCNJ2 (unexplained median 0.35 vs. hypoxia 0.41, p=0.001) had lower staining intensity in the unexplained stillbirth group. There were no statistically significant differences in the staining intensity of KCNQ1, KCNH2 and KCNE1.

CONCLUSIONS: Two ion channels associated with channelopathies demonstrated lower levels of expression in cases of unexplained stillbirth. Further genetic studies using human tissue should be performed to understand the association between channelopathies and otherwise unexplained stillbirths.

Original languageEnglish
Pages (from-to)777-785
Number of pages9
JournalJournal of Perinatal Medicine
Volume50
Issue number6
DOIs
Publication statusPublished - 26 Jul 2022

Keywords

  • Case-Control Studies
  • Channelopathies/complications
  • Eosine Yellowish-(YS)
  • Female
  • Humans
  • Hypoxia
  • Infant
  • KCNQ1 Potassium Channel/genetics
  • Pregnancy
  • Stillbirth

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