Preeclampsia and eclampsia: the conceptual evolution of a syndrome

American Journal of Obstetrics and Gynecology, Journal Year: 2022, Volume and Issue: 226(2), P. S786 - S803

Published: Feb. 1, 2022

Language: Английский

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The Pathophysiological, Genetic, and Hormonal Changes in Preeclampsia: A Systematic Review of the Molecular Mechanisms

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(8), P. 4532 - 4532

Published: April 20, 2024

Preeclampsia, a serious complication of pregnancy, involves intricate molecular and cellular mechanisms. Fetal microchimerism, where fetal cells persist within maternal tissues in circulation, acts as mechanistic link between placental dysfunction complications the two-stage model preeclampsia. Hormones, complements, cytokines play pivotal roles pathophysiology, influencing immune responses, arterial remodeling, endothelial function. Also, soluble HLA-G, involved maternal–fetal tolerance, is reduced Hypoxia-inducible factor 1-alpha (Hif-α) dysregulation leads to abnormalities preeclampsia-like symptoms. Alterations matrix metalloproteinases (MMPs), endothelins (ETs), chemokines, contribute defective trophoblast invasion, dysfunction, inflammation. Preeclampsia’s genetic complexity includes circRNAs, miRNAs, lncRNAs. CircRNA_06354 linked early-onset preeclampsia by invasion via hsa-miR-92a-3p/VEGF-A pathway. The C19MC, especially miR-519d miR-517-5p, affects Additionally, lncRNAs like IGFBP1 EGFR-AS1, along with protein-coding genes, impact regulation angiogenesis, both growth. Besides aberrations CD31+ cells, other potential biomarkers such MMPs, hCG hold promise for predicting its complications. Therapeutic interventions targeting factors peroxisome PPAR-γ endothelin receptors show mitigating preeclampsia-related In conclusion, complex disorder multifactorial etiology pathogenesis. hormones, Identifying novel therapeutic targets offers early diagnosis effective management, ultimately reducing morbidity mortality. However, further research warranted translate these findings into clinical practice enhance outcomes at-risk women.

Language: Английский

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First trimester risk of preeclampsia and rate of spontaneous birth in patients without preeclampsia

American Journal of Obstetrics and Gynecology, Journal Year: 2024, Volume and Issue: 231(4), P. 452.e1 - 452.e7

Published: Jan. 21, 2024

Language: Английский

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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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Bioinformatics analysis of shared biomarkers and immune pathways of preeclampsia and periodontitis

BMC Pregnancy and Childbirth, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 27, 2025

Epidemiological evidence indicates that preeclampsia (PE) is associated with comorbidities such as periodontitis (PD). However, the underlying mechanism remains unclear. To enhance our understanding of their co-pathogenesis, this research investigated shared biomarkers and pathological mechanisms. We systematically retrieved transcriptomic datasets from Gene Expression Omnibus database. These encompass a comparative analysis periodontium without PD placenta PE. Differentially Expressed Genes Analysis Weighted Go-expression Network (WGCNA) were used to identify key crosstalk genes in patients The functional characterisation these was performed using enrichment analysis. Protein–protein interaction networks machine learning methods leveraged hub genes. XG-Boost algorithm applied construct diagnostic models gain insight into disease aetiology. identified validated by single-cell RNA sequencing ensure robustness biological relevance. A total 55 identified, which primarily enriched immune-related pathways limma WGCNA. Among them, twenty-four protein–protein methods. model constructed outperformed other two (area under receiver operating characteristic curve [ROC] = 0.7786 0.7454 for PE PD, respectively). Pathways involving mapped Kyoto Encyclopedia Genomes In addition, showed expression BIN2, LYN, PIK3AP1, NEDD9 neutrophils significantly downregulated, LYN fibroblasts endothelial cells consistently upregulated. Shared immunologic characterised between NEDD9, suggesting pathogenesis could pave way development effective diagnostic, treatment, management strategies.

Language: Английский

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COVID-19 and pregnancy: clinical outcomes; mechanisms, and vaccine efficacy

Translational research, Journal Year: 2022, Volume and Issue: 251, P. 84 - 95

Published: Aug. 12, 2022

Language: Английский

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Preeclampsia and severe acute respiratory syndrome coronavirus 2 infection: a systematic review

Journal of Hypertension, Journal Year: 2022, Volume and Issue: 40(9), P. 1629 - 1638

Published: July 22, 2022

Objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of disease 2019 (COVID-19) that has rapidly spread worldwide, causing hundreds thousand deaths. Normal placentation characterized by many processes strictly regulated during pregnancy. If impaired, it can lead to gestational disorders, such as preeclampsia a multisystem disorder occurs in 2–8% pregnancies worldwide. Methods: We performed systematic search understand potential involvement SARS-CoV-2 onset using databases, PubMed and Web Science until 31 January 2022. Results: infection not only causes damage system but also infect human placenta cells impairing pivotal necessary for normal development. The inflammatory response trigged COVID-19 very similar one found suggesting possible link between Conclusion: Some studies showed affected had higher incidence compared with SARS-CoV-2-negative ones. However, increased blood pressure does allow associate hypertension common factor both conditions. At present, no diagnostic tools are available discriminate real from preeclampsia-like patients infection. Thus, new specific assure an appropriate diagnosis these patients, especially case severe disease.

Language: Английский

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Preeclampsia epidemiology(ies) and pathophysiology(ies)

Best Practice & Research Clinical Obstetrics & Gynaecology, Journal Year: 2024, Volume and Issue: 94, P. 102480 - 102480

Published: Feb. 22, 2024

Preeclampsia/eclampsia was first described 2000 years ago. Concepts guiding diagnosis have changed over time making longitudinal studies challenging. Similarly, concepts of pathophysiology evolved from eclampsia as a pregnancy seizure disorder to preeclampsia hypertensive and renal our current concept specific, multisystemic inflammatory disorder. Although is specific many pathophysiologic findings begin resolve with delivery, its impact extends beyond pregnancy. The risk cardiovascular neurological disease increased after in women who had preeclampsia. not disease, but syndrome emerging data indicate multiple pathways the syndrome. It likely that failure major on prediction prevention despite large increase understanding due existence subtypes This should guide future research.

Language: Английский

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Immunologic aspects of preeclampsia

AJOG Global Reports, Journal Year: 2024, Volume and Issue: 4(1), P. 100321 - 100321

Published: Feb. 1, 2024

Preeclampsia is a syndrome with multiple etiologies. The diagnosis can be made without proteinuria in the presence of dysfunction at least one organ associated hypertension. common pathophysiological pathway includes endothelial cell activation, intra vascular inflammation and syncytiotrophoblast stress. There evidence to support, among others, immunological causes preeclampsia. Unlike defense immunology, reproductive immunology not based on recognition systems self-non-self missing-self but immunotolerance maternal-fetal cellular interactions. main mechanisms immune escape from fetal maternal immunity interface are reduced major histocompatibility complex by trophoblast cells, complement regulators, increased production indoleamine 2,3-dioxygenase, activation regulatory T cells an increase check points. These protections closer those tumor process than allograft. role non-immune decidual critical for regulation invasion remodeling uterine spiral arteries. Regulatory have been found play important suppressing effectiveness other contributing local immunotolerance. Decidual natural killer cytokine profile that favored HLA-G HLA-E contributes remodeling. Studies evolution mammals show HLA-E, HLA-G, HLA-C1/C2 expressed trophoblasts their cognate receptors, necessary development hemochorial placenta or inhibition depends different possible combinations between immunoglobulin-like antigens, trophoblasts. Polarization macrophages phenotype 2 decidualization stromal also essential high quality Knowledge various required adequate case pre-eclampsia, opens new avenues research identify novel biological markers therapeutic targets predict prevent onset

Language: Английский

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Effect of Physical Activity during Pregnancy on the Risk of Hypertension Disorders and Gestational Diabetes: Evidence Generated by New RCTs and Systematic Reviews

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(8), P. 2198 - 2198

Published: April 11, 2024

Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are the most common medical complications in pregnancy. Physical exercise is considered to be safe beneficial during Moreover, could as an opportunity for healthcare providers promote positive lifestyle behavior optimize well-being pregnant women. Since there few up-to-date reviews evaluating role risks developing obstetrical complications, we performed a review investigate effects physical activity compared control group, focusing on risk development HDP GDM. We searched Medline Web Science, including only randomized controlled trials (RCTs) systematic reviews. This supports effect provides evidence that it significantly decreases

Language: Английский

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