Pre-eclampsia: pathophysiology and clinical implications

BMJ, Год журнала: 2019, Номер unknown, С. l2381 - l2381

Опубликована: Июль 15, 2019

Abstract Pre-eclampsia is a common disorder that particularly affects first pregnancies. The clinical presentation highly variable but hypertension and proteinuria are usually seen. These systemic signs arise from soluble factors released the placenta as result of response to stress syncytiotrophoblast. There two sub-types: early late onset pre-eclampsia, with others almost certainly yet be identified. Early pre-eclampsia arises owing defective placentation, whilst may center around interactions between normal senescence maternal genetic predisposition cardiovascular metabolic disease. causes, placental maternal, vary among individuals. Recent research has focused on placental-uterine in pregnancy. aim now translate these findings into new ways predict, prevent, treat pre-eclampsia.

Язык: Английский

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Pathophysiology of placental-derived fetal growth restriction

American Journal of Obstetrics and Gynecology, Год журнала: 2018, Номер 218(2), С. S745 - S761

Опубликована: Фев. 1, 2018

Язык: Английский

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Human placenta and trophoblast development: key molecular mechanisms and model systems

Cellular and Molecular Life Sciences, Год журнала: 2019, Номер 76(18), С. 3479 - 3496

Опубликована: Май 3, 2019

Abnormal placentation is considered as an underlying cause of various pregnancy complications such miscarriage, preeclampsia and intrauterine growth restriction, the latter increasing risk for development severe disorders in later life cardiovascular disease type 2 diabetes. Despite their importance, molecular mechanisms governing human placental formation trophoblast cell lineage specification differentiation have been poorly unravelled, mostly due to lack appropriate cellular model systems. However, over past few years major progress has made by establishing self-renewing stem cells 3-dimensional organoids from blastocysts early tissues opening path detailed investigations. Herein, we summarize present knowledge about development, its cells, progenitors differentiated types epithelium villous core. Anatomy placenta, current systems, critical key regulatory factors signalling cascades will be elucidated. In this context, discuss role developmental pathways Wingless Notch, controlling stemness/differentiation invasive progenitors, respectively.

Язык: Английский

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Pregnancy and COVID-19

Physiological Reviews, Год журнала: 2020, Номер 101(1), С. 303 - 318

Опубликована: Сен. 24, 2020

There are many unknowns for pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. Clinical experience of pregnancies complicated with infection by other coronaviruses e.g., Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Syndrome, has led to woman being considered potentially vulnerable severe SARS-CoV-2 infection. Physiological changes pregnancy have a significant impact on immune system, respiratory cardiovascular function, coagulation. These may positive or negative effects COVID-19 progression. The in remains be determined, concerted, global effort is required determine implantation, fetal growth development, labor, neonatal health. Asymptomatic presents further challenge regarding service provision, prevention, management. Besides direct impacts disease, plethora indirect consequences pandemic adversely affect maternal health, including reduced access reproductive health services, increased mental strain, socioeconomic deprivation. In this review, we explore current knowledge highlight areas research minimize its their children.

Язык: Английский

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Regulation of Placental Development and Its Impact on Fetal Growth—New Insights From Mouse Models

Frontiers in Endocrinology, Год журнала: 2018, Номер 9

Опубликована: Сен. 27, 2018

The placenta is the chief regulator of nutrient supply to growing embryo during gestation. As such, adequate placental function instrumental for developmental progression throughout intrauterine development. One most common complications pregnancy insufficient growth fetus, a problem termed restriction (IUGR) that frequently rooted in malfunctional placenta. Together with conventional gene targeting approaches, recent advances screening mouse mutants defects, combined ability rapidly induce mutations vitro and vivo by CRISPR-Cas9 technology, has provided new insights into contribution genome normal Most importantly, these data have demonstrated far more genes are required placentation than previously appreciated. Here, we provide summary types defects established mutants, which will help us gain better understanding impacting on human placentation. Based mutant screen, then examples how can be mined identify novel molecular hubs may critical Given close association between abnormal cardiovascular brain development, functional nodes also shed light onto etiology birth co-occur malformations. Taken together, regulation development opened up avenues research promote study conditions, notably those based underlie pathologies such as IUGR pre-eclampsia.

Язык: Английский

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Epidemiology and determinants of type 2 diabetes in south Asia

The Lancet Diabetes & Endocrinology, Год журнала: 2018, Номер 6(12), С. 966 - 978

Опубликована: Окт. 1, 2018

Язык: Английский

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Physiology and Pathophysiology of Steroid Biosynthesis, Transport and Metabolism in the Human Placenta

Frontiers in Pharmacology, Год журнала: 2018, Номер 9

Опубликована: Сен. 12, 2018

The steroid hormones progestagens, estrogens, androgens and glucocorticoids as well their precursor cholesterol are required for successful establishment maintenance of pregnancy proper development the fetus. human placenta forms at interface maternal fetal circulation. It participates in biosynthesis metabolism steroids regulated exchange between compartment. This review outlines mechanisms placental handling compounds. Cholesterol is transported from mother to offspring involving lipoprotein receptors such low-density receptor (LDLR) scavenger class B type I (SRB1) ATP-binding cassette (ABC)-transporters, ABCA1 ABCG1. Additionally, also a progesterone estrogen synthesis. Hormone synthesis predominantly performed by members cytochrome P-450 (CYP) enzyme family including CYP11A1 or CYP19A1 hydroxysteroid dehydrogenases (HSD) 3β-HSD 17β-HSD. Placental requires delivery sulfate-conjugated molecules serum. uptake these precursors mediated solute carrier (SLC) sodium-dependent organic anion transporter (SOAT), 4 (OAT4), transporting polypeptide 2B1 (OATP2B1). Maternal-fetal glucocorticoid transport has be tightly order ensure healthy growth development. For that purpose, expresses enzymes 11β-HSD 1 2 ABCB1. article summarizes impact diverse compounds diseases on expression level activity involved transporters, receptors, metabolizing concludes regulatory changing physiological pathophysiological state barely explored. structure cellular composition barrier introduced. While production, syncytiotrophoblast have been explored decades, few information available role placental-fetal endothelial cells processes. With regard function, significant differences exist species. To further decipher physiologic pathways pathologic alterations handling, model systems mandatory.

Язык: Английский

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Perfluoroalkyl Substances (PFAS) and Their Effects on the Placenta, Pregnancy, and Child Development: a Potential Mechanistic Role for Placental Peroxisome Proliferator–Activated Receptors (PPARs)

Current Environmental Health Reports, Год журнала: 2020, Номер 7(3), С. 222 - 230

Опубликована: Авг. 18, 2020

Язык: Английский

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Maternal vascular malperfusion of the placental bed

Apmis, Год журнала: 2018, Номер 126(7), С. 551 - 560

Опубликована: Июль 1, 2018

Maternal vascular malperfusion ( MVM ) of the placental bed represents a recognizable pattern injury related to altered uterine and intervillous blood flow. consists constellation pathologic findings seen in maternal decidual vessels, reflecting abnormal spiral artery remodeling, as well villous parenchyma, abnormalities oxygenation flow dynamics space. This review is dedicated gross pathology, microscopic updated terminology, clinical implications .

Язык: Английский

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Maternal-Fetal Inflammation in the Placenta and the Developmental Origins of Health and Disease

Frontiers in Immunology, Год журнала: 2020, Номер 11

Опубликована: Ноя. 13, 2020

Events in fetal life impact long-term health outcomes. The placenta is the first organ to form and site of juxtaposition between maternal circulations. Most diseases pregnancy are caused by, impact, or reflected placenta. purpose this review describe main inflammatory processes placenta, discuss their immunology, relate short- disease associations. Acute placental inflammation (API), including responses corresponds clinical diagnosis chorioamnionitis associated with respiratory neurodevelopmental diseases. chronic pathologies (CPI), include villitis unknown etiology, deciduitis, chorionitis, eosinophilic T-cell vasculitis, histiocytic intervillositis. These less-well studied, but have complex immunology show mechanistic impacts on immune system. Overall, much work remains be done describing offspring health.

Язык: Английский

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