Failure of decidual arteriolar remodeling in the CBA/J × DBA/2 murine model of recurrent pregnancy loss is linked to increased expression of tissue inhibitor of metalloproteinase 2 (TIMP-2)

Objective Uterine vascular remodeling at mid gestation includes the thinning of the vessel walls and, typically, an increase in lumen diameter. This study aimed to elucidate any differences in structural remodeling in normal murine pregnancies versus those differences that resulted from the crossing of CBA/J female mice by DBA/2 male mice, a combination that is known to exhibit recurrent resorption/pregnancy loss. Study design CBA/J female mice that were pregnant by DBA/2 male mice (abnormals) and DBA/2 female mice that were pregnant by CBA/J male mice (normals) were killed at mid gestation, which is a time when fetal resorption can be identified. Tissues were collected for permanent fixation and gene expression studies with complementary DNA macroarrays that were specific for extracellular matrix proteins. A 2-fold increase in expression or a 50% decline was considered significant. Expression changes were confirmed by real-time reverse transcriptase–polymerase chain reaction. Results The vessel-to-lumen diameter ratios were found to be significantly greater for the CBA/J implantation sites (1.50 ± 0.05 vs 1.22 ± 0.02, respectively; P< .0001), which indicates a lack of vascular remodeling. There was also a trend towards smaller lumen diameters for the CBA/J vessels, but this was not statistically significant (78.2 ± 4.4 μm vs 93.5 ± 6.8 μm, respectively; P = .22). The mean coefficient of variation for lumen measurements was 0.8% and for vessel diameter was 0.3%. The ranges were 0 to 3.2% and 0 to 1.4%, respectively. Tissue inhibitor of metalloproteinase 2 expression was up-regulated in the placentas of the group with higher resorption rates when compared with normals. This was confirmed with reverse transcriptase–polymerase chain reaction, where abnormals exhibited 2.6-fold greater tissue inhibitor of metalloproteinase 2 protein quantities when compared with normal controls (P = .03). Conclusion The expansive vascular remodeling of decidual vessels that is characteristic of normal murine pregnancy is attenuated significantly in the CBA/J × DBA/2 mating combination, which is known for its tendency to recurrent fetal resorption. This has been correlated with a relative overexpression of tissue inhibitor of metalloproteinase 2 protein in placentas of this strain combination and compared with normals.