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Article Open Access

Prospective study of cesarean scar pregnancy associated with increased MCP‑1 and cholesterol synthesis

  • Authors:
    • Qiongwei Wu
    • Jiao Fan
    • Qingjing Sheng
    • Xiaoying He
  • View Affiliations / Copyright

    Affiliations: Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai 200120, P.R. China
    Copyright: © Wu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 148
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    Published online on: June 26, 2025
       https://doi.org/10.3892/br.2025.2026
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Abstract

In the present study, it was investigated whether gestational trophoblast localization at the cesarean scar was associated with increased monocyte chemoattractant protein‑1 (MCP‑1) and cholesterol synthesis in women's blood and decidual stromal cells. Patients who underwent abortion at 6‑10 weeks of gestation were divided into three groups: cesarean scar pregnancy (CSP), normal intrauterine pregnancy without history of cesarean section (NP), and normal intrauterine pregnancy after cesarean section (NPACS). Blood and decidual tissue at the localization of the gestational sacs were collected from the patients, and RNA sequencing, PCR and ELISA were used to detect differences in the expression of thrombin receptor protease‑activated receptor‑1 (PAR‑1), MCP‑1, CCR2, chemokine (C‑C motif) receptor 2 (CCR2) and cholesterol synthesis‑related proteins sterol regulatory element‑binding protein 2 (SREBP2), 3‑hydroxy‑3‑methylglutaryl‑CoA reductase (HMGCR) and hydroxy‑methyl‑glutaryl Coenzyme A synthase (HMGCS). The expression of PAR‑1, MCP‑1, CCR2, SREBP2, HMGCR and HMGCS in the blood and the decidual stromal cells at the localization of the gestational sac was significantly higher in women with CSP than in the other two groups of patients, whereas the expression of these molecules between NP group and NPACS were not significantly different, and the total blood cholesterol levels of women with cesarean scar pregnancies were significantly higher than those of the other two groups. The development of CSP was associated with a high cholesterol environment and increased MCP‑1 expression in women.
View Figures

Figure 1

A representative ultrasound of early
pregnancy.

Figure 2

Increased MCP-1 and cholesterol
synthesis in decidual stromal cells localized at the gestational
sac of women with CSP. (A) Heat map results of decidual stromal
cell chemokine and chemokine receptor extracted from the
gestational sac localization of the three groups of patients. (B)
Volcano map results of two-by-two comparison of chemokine and
chemokine receptor of decidual stromal cells extracted from
patients' gestational sac localization. (C) Gene expression of
PAR-1, MCP-1 and CCR2 in decidual stromal cells extracted from
patients' gestational sac localization in the three groups. (D)
Gene expression of SREBP2, HMGCR and HMGCS in decidual stromal
cells extracted from patients' gestational sac localization in the
three groups. Data are expressed as the mean ± standard deviation.
ns, P>0.05 and ***P<0.001. MCP-1, monocyte
chemoattractant protein-1; CSP, cesarean scar pregnancy; PAR-1,
protease-activated receptor-1; CCR2, chemokine (C-C motif) receptor
2; SREBP2, sterol regulatory element-binding protein 2; HMGCR,
hydroxy-3-methylglutaryl-CoA reductase; HMGCS,
hydroxy-methyl-glutaryl Coenzyme A synthase; NP, normal
intrauterine pregnancy without history of cesarean section; NPACS,
normal intrauterine pregnancy after cesarean section; ns, not
significant (P>0.05).

Figure 3

Increased blood MCP-1 and cholesterol
synthesis in women with CSP. (A) Detection of PAR-1, MCP-1, CCR2,
SREBP2, HMGCR and HMGCS concentrations in the blood of three groups
of patients. (B) Comparison of blood cholesterol levels in three
groups of patients. Data are expressed as the mean ± standard
deviation. **P<0.01 and ***P<0.001.
MCP-1, monocyte chemoattractant protein-1; CSP, cesarean scar
pregnancy; PAR-1, protease-activated receptor-1; CCR2, chemokine
(C-C motif) receptor 2; SREBP2, sterol regulatory element-binding
protein 2; HMGCR, hydroxy-3-methylglutaryl-CoA reductase; HMGCS,
hydroxy-methyl-glutaryl Coenzyme A synthase; NP, normal
intrauterine pregnancy without history of cesarean section; NPACS,
normal intrauterine pregnancy after cesarean section; ns, not
significant (P>0.05).
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Spandidos Publications style
Wu Q, Fan J, Sheng Q and He X: Prospective study of cesarean scar pregnancy associated with increased MCP‑1 and cholesterol synthesis. Biomed Rep 23: 148, 2025.
APA
Wu, Q., Fan, J., Sheng, Q., & He, X. (2025). Prospective study of cesarean scar pregnancy associated with increased MCP‑1 and cholesterol synthesis. Biomedical Reports, 23, 148. https://doi.org/10.3892/br.2025.2026
MLA
Wu, Q., Fan, J., Sheng, Q., He, X."Prospective study of cesarean scar pregnancy associated with increased MCP‑1 and cholesterol synthesis". Biomedical Reports 23.3 (2025): 148.
Chicago
Wu, Q., Fan, J., Sheng, Q., He, X."Prospective study of cesarean scar pregnancy associated with increased MCP‑1 and cholesterol synthesis". Biomedical Reports 23, no. 3 (2025): 148. https://doi.org/10.3892/br.2025.2026
Copy and paste a formatted citation
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Spandidos Publications style
Wu Q, Fan J, Sheng Q and He X: Prospective study of cesarean scar pregnancy associated with increased MCP‑1 and cholesterol synthesis. Biomed Rep 23: 148, 2025.
APA
Wu, Q., Fan, J., Sheng, Q., & He, X. (2025). Prospective study of cesarean scar pregnancy associated with increased MCP‑1 and cholesterol synthesis. Biomedical Reports, 23, 148. https://doi.org/10.3892/br.2025.2026
MLA
Wu, Q., Fan, J., Sheng, Q., He, X."Prospective study of cesarean scar pregnancy associated with increased MCP‑1 and cholesterol synthesis". Biomedical Reports 23.3 (2025): 148.
Chicago
Wu, Q., Fan, J., Sheng, Q., He, X."Prospective study of cesarean scar pregnancy associated with increased MCP‑1 and cholesterol synthesis". Biomedical Reports 23, no. 3 (2025): 148. https://doi.org/10.3892/br.2025.2026
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