The effect of hypoxia on SPINT2 expression in placental cells. SPINT2 mRNA and protein secretion was measured in the following three types of trophoblast cultures: primary trophoblasts isolated from term placentas, and first-trimester cytotrophoblast and syncytiotrophoblast from a stem cell line. In the term primary trophoblasts (a), SPINT2 transcripts were significantly increased in response to hypoxia, while secreted protein levels (b) were not changed. Hypoxic conditions caused no alteration to the first-trimester cytotrophoblast stem cell SPINT2 mRNA (c), but did significantly increase the levels of SPINT2 secretion (d) compared to normoxic controls. The syncytialised first-trimester stem cells had no change in mRNA (e), although they did demonstrate decreased SPINT2 secretion (f). Experiments were repeated n = 3–5 times; data are expressed as mean ± SEM. In placentas from a rat model of uteroplacental insufficiency, changes were identified in rat SPINT2 mRNA (rSpint2) expression in both the basalis (g) and labyrinth (h) zones, being depressed and elevated, respectively. Each data point represents an individual rat placenta; data are expressed as median ± IQR; * p < 0.05, ** p < 0.01.