A Narrative Review on the Pathophysiology of Preeclampsia

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(14), P. 7569 - 7569

Published: July 10, 2024

Preeclampsia (PE) is a multifactorial pregnancy disorder characterized by hypertension and proteinuria, posing significant risks to both maternal fetal health. Despite extensive research, its complex pathophysiology remains incompletely understood. This narrative review aims elucidate the intricate mechanisms contributing PE, focusing on abnormal placentation, systemic response, oxidative stress, inflammation, genetic epigenetic factors. synthesizes findings from recent studies, clinical trials, meta-analyses, highlighting key molecular cellular pathways involved in PE. The integrates data stress biomarkers, angiogenic factors, immune interactions, mitochondrial dysfunction. PE initiated poor placentation due inadequate trophoblast invasion improper spiral artery remodeling, leading placental hypoxia. triggers release of anti-angiogenic factors such as soluble fms-like tyrosine kinase-1 (sFlt-1) endoglin (sEng), causing widespread endothelial dysfunction inflammation. Oxidative abnormalities, dysregulation further exacerbate condition. Genetic modifications, including polymorphisms Fms-like kinase 1 (FLT1) gene altered microRNA (miRNA) expression, play critical roles. Emerging therapeutic strategies targeting angiogenesis, specific like heme oxygenase-1/carbon monoxide (HO-1/CO) cystathionine gamma-lyase/hydrogen sulfide (CSE/H2S) show promise mitigating preeclampsia's effects. with origins involving dysfunction, stress. advances understanding pathophysiology, effective prevention treatment remain limited. Continued research essential develop targeted therapies that can improve outcomes for mothers their babies.

Language: Английский

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Circulating miRNAs and Preeclampsia: From Implantation to Epigenetics

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(3), P. 1418 - 1418

Published: Jan. 24, 2024

In this review, we comprehensively present the literature on circulating microRNAs (miRNAs) associated with preeclampsia, a pregnancy-specific disease considered primary reason for maternal and fetal mortality morbidity. miRNAs are single-stranded non-coding RNAs, 20–24 nt long, which control mRNA expression. Changes in miRNA expression can induce variation relative level influence cellular homeostasis, strong presence of all body fluids has made them useful biomarkers several diseases. Preeclampsia is multifactorial disease, but etiopathogenesis remains unclear. The functions trophoblasts, including differentiation, proliferation, migration, invasion apoptosis, essential successful pregnancy. During early stages placental development, trophoblasts strictly regulated by molecular pathways; however, an imbalance these pathways lead to severe lesions pregnancy complications. We then discuss role trophoblast pathogenesis, diagnosis prediction preeclampsia. also potential from epigenetic perspective possible future therapeutic implications.

Language: Английский

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The Role of Xanthine Oxidase in Pregnancy Complications: A Systematic Review

Antioxidants, Journal Year: 2024, Volume and Issue: 13(10), P. 1234 - 1234

Published: Oct. 14, 2024

Xanthine oxidoreductase (XOR) is an enzyme involved in the oxidation of hypoxanthine and xanthine to uric acid. XOR has two isoforms: dehydrogenase oxidase (XO). XO plays a major role oxidative stress, causing formation reactive oxygen species. In present study, we aimed summarize evidence on association between pregnancy complications. The PRISMA checklist guided reporting data. We conducted systematic searches PubMed Web Science databases identify all human studies investigating diseases up June 2024. A total 195 references have been identified 14 were included. Most focused women with PE GD. Overall, included found statistically significant increase maternal, placental, and/or fetal levels, activity, or tissue expression complications, compared those uncomplicated pregnancies. Although promising, quality dimension do not allow for definitive answer question whether may play crucial Future are warranted confirm if could represent prognostic therapeutic marker complications their impact long-term maternal offspring cardiovascular health.

Language: Английский

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First Trimester Placental Biomarkers for Pregnancy Outcomes

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(11), P. 6136 - 6136

Published: June 2, 2024

The placenta plays a key role in several adverse obstetrical outcomes, such as preeclampsia, intrauterine growth restriction and gestational diabetes mellitus. early identification of at-risk pregnancies could significantly improve the management, therapy prognosis these pregnancies, especially if are identified first trimester. aim this review was to summarize possible biomarkers that can be used diagnose placental dysfunction and, consequently, pregnancies. We divided into proteins non-proteins. Among protein biomarkers, some already clinical practice, sFLT1/PLGF ratio or PAPP-A; others not yet validated, HTRA1, Gal-3 CD93. In literature, many studies analyzed but their results contrasting. On other hand, non-protein miR-125b, miR-518b miR-628-3p, seem linked an increased risk complicated pregnancy. Thus, trimester heterogeneous panel containing may more appropriate identify discriminate complications affect

Language: Английский

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Behind the Curtain of Abnormal Placentation in Pre-Eclampsia: From Molecular Mechanisms to Histological Hallmarks

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(14), P. 7886 - 7886

Published: July 18, 2024

Successful human pregnancy needs several highly controlled steps to guarantee an oocyte’s fertilization, the embryo’s pre-implantation development, and its subsequent implantation into uterine wall. The placenta development ensures adequate fetal nutrition oxygenation, with trophoblast being first cell lineage differentiate during this process. sustains growth of fetus by providing it oxygen nutrients removing waste products. It is not surprising that issues early can lead common disorders, such as recurrent miscarriage, restriction, pre-eclampsia, stillbirth. Understanding normal essential for recognizing contextualizing any pathological aberrations may occur. effects these become apparent until later in pregnancy, mid or advanced stages. This review discusses process embryo phase, molecular mechanisms involved, abnormalities those are thought contribute pre-eclampsia. also covers histological hallmarks pre-eclampsia found examination placental tissue from patients.

Language: Английский

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Preeclampsia as a Study Model for Aging: The Klotho Gene Paradigm

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(3), P. 902 - 902

Published: Jan. 22, 2025

Aging and pregnancy are often considered opposites in a woman’s biological timeline. is defined by gradual decline the functional capabilities of an organism over its lifetime, while characterized presence transient placenta, which fosters cellular fitness necessary to support fetal growth. However, context preeclampsia, aging share common hallmarks, including clinical complications, altered phenotypes, heightened oxidative stress. Furthermore, women with pregnancies complicated preeclampsia tend experience age-related disorders earlier than those healthy pregnancies. Klotho, gene discovered fortuitously 1997 researchers studying mechanisms, primarily expressed kidneys but also lesser extent several other tissues, placenta. The Klotho protein membrane-bound that, upon cleavage ADAM10/17, released into circulation as soluble (sKlotho) where it plays role modulating This review focuses on involvement sKlotho development disorders, well expression recently Mytho gene, has been associated skeletal muscle atrophy.

Language: Английский

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Investigation of the Relationship Between IL-17, IL-27, IL-2 Blood Levels in Spontaneous Abortion and Healthy Pregnant Women

Life, Journal Year: 2025, Volume and Issue: 15(3), P. 326 - 326

Published: Feb. 20, 2025

Background: Cytokines are essential for regulating immune cell activity during pregnancy. Research shows that CD4+ T-cells exhibit specific cytokine secretion patterns, resulting in polarized responses. This study aims to compare the gene expression levels of Th1, Th2, and Th17 cytokines women with normal pregnancies versus those a history recurrent spontaneous abortion (RSA). Methods: In this case-control study, 20 patients RSA within 24 h their last were compared pregnant no (Control Group). Cytokine IL-2, IL-17, IL-27 quantified using real-time polymerase chain reaction (RT-PCR). Results: Overall similar between groups, but both groups generally similar. However, higher IL-17 IL-2 observed healthy pregnancy group (p = 0.006 p 0.001, respectively). Elevated pregnancies, whereas lower seen shortly after miscarriage. significantly abortions < 0.001). Conclusions: may be risk factor RSA. Consistent recent studies, our findings emphasize role as crucial regulatory maintaining successful

Language: Английский

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Long-term microvascular and blood pressure dysregulation after Preeclampsia

Hypertension Research, Journal Year: 2025, Volume and Issue: unknown

Published: April 2, 2025

Language: Английский

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Editorial: Gestational diabetes: where are we and where are we going?

Frontiers in Clinical Diabetes and Healthcare, Journal Year: 2024, Volume and Issue: 5

Published: Nov. 22, 2024

Gestational diabetes mellitus (GDM) is a complex and increasingly prevalent condition that poses significant challenges to maternal fetal health, as well public healthcare costs. In this special issue, we present collection of studies highlighting innovative approaches GDM management. These include the use technology, such integrated bioinformatics analysis data-driven clusters, insights into pathophysiology risk factors.GDM defined glucose intolerance develops during pregnancy, typically diagnosed second or third trimester. The current prevalence in Europe estimated be around 10.9% based on recent meta-analysis (1). Rates are rising globally, partly explained by increasing obesity age. International association pregnancy study groups recommendations diagnosis classification hyperglycemia (IADPSG) suggest diagnostic criteria: fasting plasma (FPG) ≥5.1 mmol/L (92 mg/dL); 1-hour ≥10.0 (180 mg/dL) and/or 2-hour ≥8.5 (153 75 g oral tolerance test (2). Known factors for development obesity, advanced age, family history type 2 (T2DM), polycystic ovary syndrome, with other under (3). Interestingly, published issue Hui Liu colleagues, highest quartile liver function index (LFI) was linked heightened GDM, odds ratios (OR) ranging from 1.29 3.15. Additionally, noteworthy interaction between AST/ALT levels triglycerides (TG) identified regarding (P = 0.026). TG have also been associated vascular dysfunction, being possible common pathophysiologic mechanism hypertensive disorders (4). As Authors reported, found heterogenous results different markers, associations GGT but not AST ALT. To overcome reverse causation, performed Mendelian randomization analysis, showing causal relationship ALT an OR 1.28 (95% CI: 1.05-1.54). metabolic dysfunction leading crucial only developing new scores better understanding GDM.The etiopathogenesis unclear, immune chronic inflammation key contributors (5,6). Elevated cytotoxic NK cells dysregulated Tregs Th17 cells, alongside cytokines like IL-6, IL-1β, TNF-α, exacerbate insulin resistance, contributing (5)(6)(7)(8). Inflammation plays role endothelial (9)(10)(11)(12) angiogenic imbalance occurrence cardiovascular diseases patients (13)(14)(15). However, microenvironment remains limited (7). Jie-ling Chen colleagues Special Issue comprehensive bioinformatic gene expression profiles two databases Human Umbilical Vein Endothelial Cells (HUVEC) RNA-seq data controls. Furthermore, evaluated six hub Differentially expressed genes (DEG) high value cells. biomarkers value, PLAUR SLIT2, had strong correlation B naïve T follicular helper, respectively. authors emphasize need animal validate their findings. context, another article within same examined cell functionality models Yujing Xiong colleagues. Decidual differ phenotype circulating (16,17). They interact fetus engaging human leukocyte antigen (HLA) ligands extravillous trophoblasts, promoting mother fetus. streptozotocin-induced model disrupted homeostasis, affecting both proportions functions analyzed women vs. controls there no differences percentage total amount single phenotypes. summary, abovementioned submitted contribute growing body literature mechanisms at basis pathophysiology, providing valuable types molecular involved.Women face increased risks complications, including preeclampsia, cesarean delivery, likelihood T2D later life. Indeed, preeclampsia share several pathophysiological pathways (3,18). can adversely affect development, higher rates macrosomia, neonatal hypoglycemia, longterm issues child (19,20). Approximately one-third using pre-IADPSG criteria will exhibit indicative prediabetes postpartum assessments 3 months delivery. Anna Lesniara-Stachon highlighted point distinction induced reduced caused peripheral resistance. This differentiation underlying guiding its management therapeutic strategies. predictors 1-year were among For belonging resistant cluster, HOMA-IR best predictor (OR 1.9). On hand, 8.7) FBG (7.8) cluster. A precision medicine approach considers subtypes could enhance diagnosis, assessment, treatment strategies.Personalized medicine, allowing recognition specific phenotypes consequent tailored treatment, long term follow-up strategies reduce diseases, translational research clarify inflammatory pathogenetic main areas addressed future GDM. Addressing these would improve prevention, condition.

Language: Английский

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Special Issue “Physiology and Pathophysiology of Placenta 2.0”

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(9), P. 4586 - 4586

Published: April 23, 2024

We are pleased to present this Special Issue of the

Language: Английский

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