SUPRIYADI HARI RESPATI (2010) EKSPRESI HUMAN LEUKOCYTE ANTIGEN-G, HEAT SHOCK PROTEIN-90, VASCULAR ENDOTHELIAL GROWTH FACTOR-A DAN KOLAGEN TIPE IV PADA MOLAHIDATIDOSA (SUATU KAJIAN BIOLOGI MOLEKULER MOLAHIDATIDOSA). Disertasi thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Background: Hidatidiform mole is a gestational trophoblastic disease (GTD), an abnormal pregnancy characterized by proliferation of trophoblastic cells, avascular chorialis villi, and underwent hydropic degeneration. Gestational trophoblastic diseases in Indonesia still pose as a great reproductive health problem, with its high prevalence, numerous risk factors, and smooth distribution. Objective: The aim of this study is to analyze the expression of HLA-G, Hsp-90, VEGF-A and type-IV collagen in the trophoblast and serum of patients with hydatidiform mole, and normal pregnancy. We aimed to analyze the possibility of causative relationship between the decrease in HLA-G expression, and the increase of Hsp-90 and type IV collagen expression, and the decrease of VEGF-A expression in hydatidiform mole. Design: This is an observational analytic study with a cross sectional design. Subjects that fulfill our sample criterion were subjected to HLA-G, Hsp-90, VEGF-A and type-IV collagen immunohystochemical examination, and ELISA study for the same proteins. Control for this study was taken from placentas of normal pregnancies. Result: Our immunohystochemical examination found out that a lower HLA-G, higher Hsp-90, lower VEGF-A and higher type IV collagen expression in samples from hydatifirorm mole, compared with throphoblast in placenta normal pregnancies (p<0.05). Using ELISA method, we found higher levels of Hsp-90 and type IV collagen in hydatidiform mole, compared with normal pregnancy (p<0.05), while the decrease of VEGF-A was not established (p<0.05). The Hsp-90 was found to be a marker for hydatidiform mole with a predictive value is 70.0%. Conclusions: the low HLA-G in trophoblast is the pathogenesis of hydatidiform mole. Hsp-90 can be used as a hydatidiform mole marker, with a prediction value is 70%.

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