{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:29:47Z","timestamp":1792762187401,"version":"4.5.0"},"reference-count":25,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Preeclampsia has been linked to an inflammatory response that may be brought on by endothelial cell dysfunction. This paper investigates the pathomechanism of syncytiotrophoblast basement membrane (STBM) damage and Placental Protein 13 (PP13) release, which may have a role in systemic endothelial dysfunction in preeclampsia. Materials and\u00a0Methods: This comparative cross-sectional study involves 54 preeclampsia patients (27 early-onset preeclampsia and 27 late-onset preeclampsia) and 27 pregnant women with normal blood pressure. An enzyme-linked immunosorbent assay was performed to evaluate maternal blood levels of PP13. Following birth, a portion of the placenta was collected for transmission electron microscope (TEM) and immunohistochemical (IHC) analysis. The data were analyzed using STATA version 15. Results: PP13 expression in the placental syncytiotrophoblast was significantly lower in the early-onset preeclampsia, compared to late-onset preeclampsia and normotensive pregnancy, group (p &lt; 0.001). In contrast, serum PP13 levels were found to be the highest in the early-onset preeclampsia group, although no significant difference were found in mean maternal serum levels of PP13 between the three groups. The decreased PP13 expression in placental syncytiotrophoblast can be attributed to the greater extent of damage in the STBM in early-onset preeclampsia that leads to the release of a larger amount of PP13 into maternal circulation. The hypothesis aligns with the TEM analysis results. Preeclamptic pregnancies showed placental syncytiotrophoblast aponeurosis, whereas normotensive pregnancies did not. Placental lesions and STBM shedding were found to be more pronounced in early-onset preeclampsia compared to late-onset preeclampsia. Conclusions: PP13 and STBM damage may play a role in systemic endothelial dysfunction in preeclampsia.<\/jats:p>","DOI":"10.3390\/medicina60071077","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T03:38:27Z","timestamp":1719805107000},"page":"1077","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Placental Protein 13 and Syncytiotrophoblast Basement Membrane Ultrastructures in Preeclampsia"],"prefix":"10.3390","volume":"60","author":[{"given":"Peby Maulina","family":"Lestari","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30114, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noroyono","family":"Wibowo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damar","family":"Prasmusinto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0786-3856","authenticated-orcid":false,"given":"Muhammad","family":"Yamin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuryati Chairani","family":"Siregar","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joedo","family":"Prihartono","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina Susianti","family":"Timan","sequence":"additional","affiliation":[{"name":"Departement of Clinical Pathology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanes C.","family":"Mose","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iche Andriyani","family":"Liberty","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Sriwijaya, Palembang 30114, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4610-4185","authenticated-orcid":false,"given":"Cindy","family":"Kesty","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30114, Indonesia"},{"name":"Tropical Diseases Research\/World Health Organization Fellow, Infectious Diseases Data Observatory, University of Oxford, Oxford, ON OX1 4BH, Canada"},{"name":"National Task Force of Reproductive Tract Infection, Indonesian Society of Obstetrics and Gynecology, Jakarta 10320, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5135-3012","authenticated-orcid":false,"given":"Bella","family":"Stevanny","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Universitas Sriwijaya, Palembang 30114, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,30]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Relevance of placental pathological changes of maternal inflammatory syndrome along with the obstetric and clinical parameters in preeclampsia","volume":"2","author":"Sharma","year":"2012","journal-title":"Int. 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