AMER. ZOOL., 32:331-342 (1992) Comparative Studies of Structure and Function in Mammalian Placentas with Special Reference to Maternal-Fetal Transfer of Iron1 BARRY F. KING Department of Cell Biology and Human Anatomy, School of Medicine, University of California, Davis, California 95616-8643 SYNOPSIS. The mammalian chorioallantoic placenta is an extremely complex and structurally diverse organ. To better understand the placenta a number of classification schemes have been devised. Classification on the basis of gross form or shape recognizes four major categories—diffuse, cotyledonary, zonary and discoid. Another important classification scheme is based on the number of tissue layers separating the maternal and fetal vascular systems in the placenta. On this basis, three major types of placentas are recognized—epitheliochorial, endotheliochorial and hemochorial. In many species, pathways in addition to the chorioallantoic placenta exist for maternal-fetal exchange. Some species have a yolk sac placenta functioning concurrently with the chorioallantoic placenta whereas in some other species exchange may occur across a chorioamnion. Some species have accessory or paraplacental structures which function in nutrient exchange; these include hemophagous regions and areolae. In the final sections, I review how these different structural specializations come into play to accomplish a particular function, namely that of iron transfer to the fetus. There are at least four different mechanisms by which different species accomplish iron transfer to the fetus. These include 1) absorption of maternal transferrin-bound iron by the placenta; 2) absorption of iron by the yolk sac; 3) phagocytosis of maternal erythrocytes and 4) absorption of iron-rich uterine secretions by accessory placental structures. INTRODUCTION The mammalian placenta is one of the most structurally complex organs there is. This complexity is brought about in part by interaction of tissues of maternal and fetal origin, by the presence of a variety of tissue layers interposed between the maternal and fetal vascular beds, and the changing relationships of these tissues and fetal membranes that occur between the time of blastocyst implantation and parturition. To further complicate matters, considerable species differences exist with regard to placental and fetal membrane structure. In this brief survey of this very broad subject area I have three basic objectives. First, I will review some of the principles of placental structure and classification in eutherian mammals. Second, I will review how this structural diversity needs to be taken into account in understanding maternal-fetal exchange in different species and even in a single species. Third, I will review how this structural diversity and complexity relates to a particular function, namely that of iron transfer to the fetus. Classification of placentas The definitive placenta of all eutherian mammals is the chorioallantoic placenta. It is classified as chorioallantoic since the chorion (trophoblast plus fetal mesoderm) is vascularized by vessels derived from the mesoderm of the allantoic stalk. Other types of placental relationships also occur, one of the most important being a yolk sac placenta. Over the years, a variety of classification schemes have been applied to the placenta. Thus, the human chorioallantoic placenta can be classified as discoidal because of itsflatcircular shape, hemochorial because of the tissue layers separating the maternal and fetal blood streams, villous because of the presence of villi, and deciduate because maternal decidual tissue is shed at parturition along with the fetal placenta. In the following sections, two of the classification schemes for placentas will be explained; for other classifications, see Ramsey (1982). 1 From the Symposium on Evolution ofViviparity in Classification by gross form or shape. — Vertebrates presented at the Annual Meeting of the One scheme for classifying placentas is by American Society of Zoologists, 27-30 December 1990, describing the distribution of outgrowths of at San Antonio, Texas. 331 332 BARRY F. KING DIFFUSE ZONARY DISCOID COTYLEDONARY FIG. 1. Major categories of placentas based on their gross form or shape. Diffuse placenta (e.g., pig); Cotyledonary (e.g., sheep); Zonary (e.g., cat, dog) and Discoid (e.g., human, rodent). Figures redrawn and adapted from Hamilton and Mossman (1972). the chorion (chorionic villi or folds) on the surface of the mature gestation sac. Using this method, four major categories are recognized (Fig. 1). In a diffuse type of placenta, projections (folds or villi) from the chorion are distributed over most of the surface of the gestation sac. This type is seen in a wide range of animals including pig, horse, whale and some primitive primates. In a cotyledonary placenta, the chorionic villi are usually restricted to oval or circular patches of the chorionic sac. Animals having this type include sheep, goats and cows. Zonary placentas have chorionic villi distributed in an equatorial band or girdle, although there are many variations in the distribution of villi. Discoidal placentas have chorionic villi distributed in a circular plate. Figure 1 has been simplified and many variations can occur within each category. For example, the number of cotyledons may vary from only a few to well over a hundred depending on the species, zonary placentas of many carnivores are often not a complete band and the placenta of the rhesus monkey is usually bidiscoidal. Additional details can be found in Amoroso (1952), Steven (1975), Ramsey (1982) and Mossman (1987). Classification by composition of the interhemal membrane.— Another scheme for classifying chorioallantoic placentas is based on the number and origin of the tissue layers separating the maternal and fetal blood. This system, originally formulated by Grosser (1909, 1927), has been modified as placentas of additional species have been examined, particularly by electron microscopy. The intervening layers are referred to as the placental barrier or membrane, or preferably the interhemal membrane (King and Mossman, 1974). The major placental types derived from this classification scheme and their tissue components are shown in Table 1. The different placental types arise as a consequence of a reduction in the number of maternal tissue layers. In an epitheliochorial placenta, the maternal uterine epithelium (epithelio) is closely interdigitated with the vascularized fetal layers (chorion). Removal of maternal epithelial and connective tissue elements brings about the apposition of maternal capillary endothelium to the chorion, resulting in an endotheliochorial classification. In a hemochorial placenta, all intervening maternal layers are eliminated and maternal blood directly 333 PLACENTAL STRUCTURE AND FUNCTION TABLE 1. Classification of chorioallantoic placentas by tissues comprising the interhemal membrane. Type of placenta Maternal tissue Endothelium Connective tissue Epithelium Fetal tissue Trophoblast Connective tissue Endothelium Common examples Main zoological groups thought to have the type of placenta indicated Epitheliochorial Endotheliochorial Horse, Pig, Cattle Perissodactyla Artiodactyla Lemuroidea Cetacea Pholidota Cat, Dog Most Carnivores Tupaiidae Bradypodidae Proboscidea Tubulidentata Hemochorial Human, Rodents, Rabbit Most Primates Rodentia Lagomorpha Some Chiroptera Dasypodidae Hyracoidea Sirenia Most Insectivora Dermoptera Adapted from Hamilton and Mossman, 1972. bathes the trophoblast. The "Grosser" system has been criticized for a number of shortcomings, the most important of which was the assumption by some early investigators that the number of tissue layers in the interhemal membrane determines its thickness and, therefore, from a physiological standpoint, was related to the "efficiency" of placental transfer. As we have come to know more about active, facilitated and endocytic transport mechanisms operating in the placenta, we can appreciate that this is a misleading oversimplification. Also, more layers do not necessarily mean thicker. In the epitheliochorial placenta of the pig, indentation of the uterine epithelium by maternal capillaries, and indentation of the trophoblast by fetal capillaries, significantly reduces the diffusional distance between the two circulations. Even placentas classified as hemochorial may have one, two or three layers of trophoblast (Enders, 1965). An example of how thinness of the interhemal membrane alone does not necessarily relate to maternal-fetal transport is seen in the case of immunoglobulin transfer to the fetus. Both the human and guinea pig fetus acquire their passive immunity during prenatal life (Brambell, 1970) and each has a chorioallantoic placenta that is hemomonochorial, i.e., only a single layer of trophoblast sep- arating maternal blood from fetal capillaries (Enders, 1965). Yet IgG is transported across the human placenta, but not that of the guinea pig. In the case of the guinea pig, transfer is by way of the yolk sac. In spite of these cautions, the Grosser system of classification has retained its usefulness. It serves as a convenient reminder of the tissue components that need to be taken into account when studying morphological, physiological, endocrinological or immunological functions of the placenta. PATHWAYS OF MATERNAL-FETAL EXCHANGE One of the major functions of the placenta is obviously to provide for the transfer of nutrients to support embryonic/fetal growth and development. Collectively these nutrient materials are sometimes referred to as embryotroph and are of two general types— histotroph and hemotroph (Amoroso, 1952). Histotroph refers to materials derived from the secretions of uterine glands, material resulting from the disintegration of maternal tissues and extravasation of maternal blood. Hemotroph is derived directly from the maternal blood stream via the placenta. It is important to bear in mind that physiological transfer of substances from mother to fetus cannot be accounted for solely by 334 BARRY F. KING FIG. 2. Diagram illustrating some of the potential pathways of maternal-fetal exchange of substances in a rodent. (1) A prominent region of exchange is the chorioallantoic placenta, where nutrients may be transferred from maternal blood to the fetal capillaries of the placenta. In pathway (2a) materials may be transferred from the edge of the chorioallantoic placenta (and parietal yolk sac) into the uterine lumen; (2b) uterine glandular secretions enter the uterine lumen; (3) contents of uterine lumen are absorbed by the endoderm cells of the visceral yolk sac and transferred to capillaries of the vitelline circulation and thence to the fetus; (4) substances absorbed by the yolk sac may reach the exocelomic cavity (EXO) and cross into the amniotic cavity (AC); (5a) substances in the amniotic fluid may be absorbed across the embryonic/fetal skin or (5b) may be swallowed by the fetus and absorbed via the fetal gut. Placental disc modified from Mossman (1987). transfer from maternal blood to fetal blood across the chorioallantoic placenta. In many species, accessory or paraplacental structures function in maternal-fetal exchange. In others, another type of placenta (most notably a yolk sac placenta) functions prior to the establishment of the chorioallantoic placenta and may function concurrently with the latter in later gestation. One type of paraplacental structure that plays an important role in nutrient transfer to the fetus is the hematoma or hemophagous organ which occurs in many species. In these regions extravasations of maternal blood occur and adjacent phagocytic trophoblast cells ingest the maternal erythrocytes. Another type of paraplacental structure is the areolae found in many ungulates. These are dome-shaped structures lined by absorptive trophoblast cells that lie opposite the openings of uterine glands. The functions of both these paraplacental structures will be considered in more detail in later sections. A variety of other types of paraplacental structures also occurs (Mossman, 1987). As mentioned above, many species may have a yolk sac placenta functioning concurrently with a chorioallantoic placenta throughout much of gestation. This has been best studied in rodents (see reviews by Brent, 1990;Jollie, 1990; King and Enders, 1991). Figure 2 illustrates some of the possible PLACENTAL STRUCTURE AND FUNCTION routes of maternal-fetal exchange in a rodent. It is evident that many possibilities exist. A somewhat similar situation exists in many primates, including humans, where the apposition of the chorioamnion with the uterine wall creates a potential route of exchange involving passage of substances into the amniotic fluid where (potentially) absorption could occur across fetal skin or gut absorption could occur as a consequence of fetal swallowing. MECHANISMS OF MATERNAL-FETAL IRON TRANSFER The mechanisms that have evolved in different mammals to provide for iron transfer to the developing embryo and fetus reveal a fascinating variety involving both placental and paraplacental structures as well as hemotrophic and histotrophic sources of the iron. At least four important mechanisms have been implicated in the transfer of iron from mother to fetus. Absorption of transferrin-bound iron by the placenta This mechanism appears to be utilized by most species with a hemochorial type of placenta (Seal et ah, 1972; Baker and Morgan, 1973; Morgan, 1980; van Dijk, 1988; Douglas and King, 1990). It is known that iron is rapidly transferred to the fetal circulation whereas transferrin is not (Gitlin et al, 1964; Contractor and Eaton, 1986). Although a number of steps in the overall process are unknown, several lines of investigation support the pathway of receptormediated endocytosis illustrated in Figure 3. Transferrin receptors are present on the apical surface of human syncytiotrophoblast bordering the maternal blood (Wada et al, 1979; Brown and Johnson, 1981; Brown et al, 1982). Transferrin binds to the membrane of microvilli and coated pits on the trophoblast surface (King, 1976). Transferrin receptors are also present on isolated human trophoblast cells (Bierings et al, 1988; Douglas and King, 1990). Trophoblast cells in culture internalize transferrin and transferrin receptors via a system of coated pits and vesicles (King, 1990). Trophoblast cells in vitro internalize transferrin by receptor-mediated endocytosis; transferrin is recycled and released back to the 335 medium, whereas iron accumulates intracellularly (Douglas and King, 1990). Iron accumulates largely in the form of ferritin although some low molecular weight iron compounds have also been detected. An iron regulatory factor and a low molecular weight iron-binding molecule have been isolated from human placenta but their precise role in maternal-fetal iron transfer remains to be determined (Neupert et al, 1990; Knisely et al, 1989). Iron-containing deposits have been described in the basement membrane area underlying the trophoblast in human placenta (for references see Salazar and Gonzales-Angulo, 1967). Corresponding electron-dense granules were described by Salazar and Gonzales-Angulo (1967) who interpreted them to result from a block to iron transfer. Hamasaki et al (1985) have provided conclusive evidence, using x-ray microprobe analysis, that these basal lamina granules contain iron but referred to the granules as lipid droplets, a conclusion for which there is no supporting evidence. Granules of similar structures were described in the seal placenta, where they were interpreted as sites of iron storage (Sinha and Erickson, 1974). The form in which iron reaches the fetal circulation remains an enigma, but once there becomes associated with fetal transferrin. Absorption of iron by the yolk sac This pathway probably is used by a number of mammals, but is best documented in rodents. The histochemical studies of Wislocki et al. (1946) noted the presence of substantial iron deposits in the rodent yolk sac as well as endometrial glands. They hypothesized secretion of iron-rich materials from the glands into the uterine lumen from where the yolk sac endoderm absorbed the compounds. Subsequent physiological studies have indicated the yolk sac has at least some role in maternal-fetal transfer of iron (Nylander, 1953; Magnusson et al, 1955; Glasser et al, 1968; Kaufman and Wyllie, 1970; Garrett et al, 1972, 1973). The relative importance of the yolk sac in iron transfer compared with the chorioallantoic placenta is the subject of some disagreement in the above-mentioned studies, perhaps due in part to variations in gestational age and 336 BARRY F. KING MATERNAL BLOOD D1FERRIC TRANSFERRIN \ y TRANSFERRIN I RECEPTOR * IRON ( 3 APOTRANSFERRIN FERR1T1N FIG. 3. Diagram illustrating some of the cellular pathways involved in the absorption of maternal transferrinbound iron by trophoblast of a hemochorial placenta such as the human. CURL, Compartment of uncoupling of receptor and ligand. to the form in which iron was administered. In the rat, Garrett et al. (1972,1973) showed the yolk sac had a significant role in iron transport during certain days of gestation and that yolk sac tissue had the capacity to take up iron from FeCl3 and from serum (transferrin). The observation by Garrett et al. (1972) that it was the "circumferential" portion of the yolk sac that was particularly important in iron uptake is intriguing. This could mean that the area was important because the yolk sac is highly villous in that region or it might mean that the "endodermal sinuses" on the surface of the chorioallantoic placenta are contributing to transport by this pathway, as has been suggested for calcium transport (Bruns et al., 1985). Recent studies have indicated that transferrin can be transported by rat yolk sac (McArdle and Priscott, 1984; Huxham and Beck, 1985; Thiriot-Hebert, 1987). This appears to occur via receptor-mediated endocytosis, and may occur early in gesta- tion, before the establishment of the chorioallantoic placenta. As gestation proceeds, the yolk sac decreases in importance and the transport system of the chorioallantoic placenta rapidly matures (McArdle and Morgan, 1982). Electron-dense, iron-containing granules have been observed in the basement membrane of a rodent yolk sac (King and Tibbitts, 1976). These are virtually identical to those described in human placenta and may represent sites of temporary iron storage. The yolk sac of the shrew Blarina also is involved in iron transport to the fetus, but in this case an unusual situation exists wherein a portion of the yolk sac becomes a hemophagous area involved in erythrophagocytosis (Wimsatt and Wislocki, 1947; King et al., 1978); in most other mammals, the fetal component of the hemophagous region is the chorioallantoic membrane, not the yolk sac (see next section). In the shrew, a specialized region of trophoblast is PLACENTAL STRUCTURE AND FUNCTION 337 TROPH FIG. 4(A). Diagram of the histological arrangements at the marginal hemophagous region of a carnivore placenta (e.g., cat). Maternal erythrocytes are extravasated from endometrial vessels (MC) into the uterine lumen (UL). Trophoblast cells of the chorion (TROPH) in this region phagocytose maternal erythrocytes and transfer maternal iron to fetal capillaries (FC). UE, uterine epithelium; UG, uterine gland. (Redrawn and adapted from Mossman, 1987.) involved in localized disruption of endometrial blood vessels and maternal blood is extravasated into the uterine lumen. Phagocytic trophoblast cells ingest and degrade maternal red cells, and iron-containing compounds are transferred to the yolk sac cavity. From here visceral yolk sac endoderm cells absorb the iron-rich components and store them as iron pigments. The storage of pigments is sufficiently great so as to impart a distinctly green color to the endoderm cells. By mechanisms unknown the iron is mobilized and transferred to other fetal tissues. Phagocytosis of maternal erythrocytes In a number of species, localized extravasations of maternal blood occur opposite regions of specialized chorion with phagocytic trophoblast cells. These accessory or paraplacental regions are known as placental hematomas, hemophagous organs (Creed and Biggers, 1964) or hemophagous regions of the placenta (Burton, 1982). Hemophagous regions occur in many carnivores, insectivores, bats and ungulates and vary greatly in location and morphology (see Wimsatt, 1962; Steven, 1975; Ramsey, 1982; Mossman, 1987). Blood from endometrial vessels is extravasated into a space (typically the uterine cavity) (Fig. 4A). The manner in which the uterine vessels are rendered leaky is poorly understood although in a few cases it appears to be due to the invasive activity of trophoblast (King et ai, 1978; Leiser and Enders, 1980). Blood which has accumulated is phagocytosed by chorionic trophoblast cells. Indeed, pigments arising from the degradation of hemoglobin results in coloration of the hemophagous regions. Thus, the marginal hematoma of the dog is referred to as the "green border," that of the cat the "brown border" and is reddish-brown in some bears (see Burton, 338 BARRY F. KING FIG. 4(B). Diagram of some of the proposed pathways of iron transfer by choricnic trophoblast cells (TROPH) of a hemophagous region. Maternal erythrocytes in the uterine lumen (UL) are engulfed and reside in erythrophagosomes (EP). Various stages of degeneration occur in erythrolysosomes (EL). Iron (Fe) may be released from hemoglobin-containing lysosomes (HLy) and stored as cytoplasmic ferritin (FeFt). The manner in which the iron exits the trophoblast, crosses the basal lamina (BL), and enters the fetal capillary (FC) is unknown. Within the capillary iron is presumably associated with fetal transferrin (FeTf). (Redrawn and adapted from Burton et ai, 1976 and Burton, 1982.) 1982). While it is generally accepted that, in species with prominent hemophagous regions, fetal iron stores are derived from breakdown of maternal erythrocyte hemoglobin, there are very few studies directly addressing this issue. Seal et al. (1972), citing unpublished experiments, used 59Fehemoglobin-labelled erythrocytes to dem- onstrate that label could subsequently be localized in the hemophagous region of the racoon placenta and also in fetal hemoglobin. Ultrastructural studies of the hemophagous regions and of the process of erythrophagocytosis have been carried out in a number of species including sheep (Myag- PLACENTAL STRUCTURE AND FUNCTION kaya and Vreeling-Sindelarova, 1976; Burton et al, 1976), seal (Sinha and Erickson, 1974), shrew (King et al, 1978), cat (Malassine, 1977, 1982; Leiser and Enders, 1980), dog (Burton, 1982) and ferret (Gulamhusein and Beck, 1975). The sequence involved in erythrophagocytosis seems similar in most species thus far examined (Fig. 4B). Microvilli or cellular processes of the trophoblast cells partially engulf whole or fragmented erythrocytes. Erythrophagosomes and erythrolysosomes are formed in the apical cytoplasm and degradation occurs. Subsequent metabolic pathways of iron in these trophoblast cells are not well understood. Hemoglobin-containing lysosomes may be the main sites of hemoglobin degradation and iron may be stored in the cytoplasm in the form of ferritin or hemosiderin (Burton, 1982; Malassine, 1982). How iron is eventually delivered to the fetal circulation is unknown, but within the fetal capillary iron is presumably associated with transferrin (Burton, 1982). In addition to questions remaining about the detailed pathway of iron transport, it is unclear whether this hemoglobin-derived iron is sufficient to meet all of the fetal requirement in these species, particularly in late gestation. Absorption of iron-containing uterine secretions In a number of species that do not have a hemochorial placenta, transferrin-bound iron has a low rate of transfer to the fetus, too low to account for most of the iron the fetus accumulates (Seal et al, 1972). Some of these species also lack hemophagous regions, leading to the suggestion that other paraplacental structures must be participating in maternal-fetal transfer of iron. In the case of the pig, evidence points to the areolae as important sites of iron transfer derived from uterine secretions (histotroph). As mentioned earlier, areolae are specializations of the chorion located opposite the mouths of uterine glands (Fig. 5) and have long been suspected as sites of nutrient transfer (Brambel, 1933; Friess et ah, 1981). Wislocki and Dempsey (1946) demonstrated the presence of non-heme iron in pig uterine glands, secretions and areolae, and called attention to the potential impor- 339 tance of the glands and areolae as a pathway for nutrient transfer. Direct experimental evidence implicating the areolae in iron transport to the fetus was provided by Palludan et al. (1970). They administered 59Fe to the mother and found that the labelled iron accumulated in the uterine glands and secretions and over the areolae. Furthermore, the iron was transported to the fetus in a non-dialyzable (presumably proteinbound) form. More recently, the composition of pig uterine secretions has been actively investigated (Roberts et al, 1986; Roberts and Bazer, 1988). One major component of porcine uterine secretions is a glycoprotein acid phosphatase that contains bound iron. Because of the evidence implicating this glycoprotein in transplacental iron transport it has been called uteroferrin (Roberts and Bazer, 1980). Uteroferrin is synthesized and secreted by the uterine gland epithelial cells. Specialized trophoblast cells lining the areolae absorb uteroferrin from the areolar lumen by an endocytic pathway (Chen et al., 1975; Renegar et al., 1982; Raub et al., 1985). Uteroferrin is transported intact from the trophoblast cells to the fetal circulation although the precise pathways involved have not been delineated (Renegar et al., 1982). Uteroferrin is distributed to fetal organs, including spleen and liver, and its iron is incorporated into fetal hemoglobin (Buhi et al., 1982). Excess uteroferrin is cleared by the fetal kidneys and enters the allantoic sac wherein additional metabolism occurs, including the transfer of its iron to transferrin (Buhi et al., 1983; Renegar et al., 1982). At least for the greater part of gestation, uteroferrin is secreted and absorbed in sufficient quantities to provide for the iron requirements of the developing fetus. Whether it is sufficient during later gestation, or whether other mechanisms are invoked, remains to be demonstrated. The above evidence provides a strong case for the involvement of paraplacental structures (areolae) and uterine secretions (histotroph) as an important mechanism of iron transport in the pig. To what extent this pathway is used in other species is largely unknown, although uteroferrin-like proteins have been 340 BARRY F. KING FIG. 5. Diagram of the general arrangements of tissues in the region of an areola of the pig placenta. Epithelial cells of the uterine glands (UG) secrete iron-rich compounds (#) such as uteroferrin into the uterine lumen (UL) and areolar space. Absorptive trophoblast cells (TROPH) of the areolar lining endocytose the secretions and transport them to underlying fetal capillaries (FC). MC, maternal capillaries. (Redrawn and modified from Mossman, 1987.) found in the horse (McDowell et ai, 1982, 1990). Also, I have postulated that a similar pathway may be used for iron transport in a primitive primate (Galago) that has an epitheliochorial placenta and paraplacental specializations (chorionic vesicles) similar in structure to areolae (King, 1984). This postulate was based not only on the many structural similarities but also on the histochemical observation that iron is present in the uterine glands and chorionic vesicles in Galago (Butler and Adam, 1964). Thus, iron transfer by this mechanism may be more common than currently appreciated. ACKNOWLEDGMENTS The author's original investigations reported herein were supported by National Institutes of Health grants HD 11658 and RR00169. I thank Grete Fry for technical assistance, Carrie Beth Mattos for rendering the drawings, Dr. A. C. Enders and Sandy Enders for reading the manuscript, and Clarrise Northern for typing the manuscript. REFERENCES Amoroso, E. C. 1952. Placentation. In A. S. 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