From molecules to medicine: a future cure for preeclampsia?
In the United States, preeclampsia (PreE) affects 5-7% of all pregnancies, yet represents 15% of all maternal-fetal morbidity and mortality. PreE causes fetal growth restriction, oligohydramnios, fetal death, and maternal seizures, stroke, cerebrovascular hemorrhage and death. It has immediate and potentially long-term effects on both the fetus and mother. To date, the molecular pathogenesis of PreE is largely unknown. Multiple pathways, including dysfunctional angiogenesis, inappropriate placentation, oxidative stress and an altered immunological milieu have been proposed as key players in the development of PreE. In addition, genetic factors in all of these pathways are essential components in the etiology of this disease. This review introduces the clinical presentation of PreE and its particular disease phenotype that has prompted some of the molecular investigations of its etiology. Evidence of the many molecular pathways involved in the pathogenesis of PreE, as well as the therapeutic investigations targeting these pathways, is presented.
Santillan
Mark K
MK
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Iowa Hospitals and Clinics, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA. mark-santillan@uiowa.edu
Santillan
Donna A
DA
Sigmund
Curt D
CD
Hunter
Stephen K
SK
D000818:Animals; D000959:Antihypertensive Agents / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D015195:Drug Design; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007107:Immune System / Q000187:drug effects / Q000503:physiopathology; D018384:Oxidative Stress; D010641:Phenotype; D010920:Placenta / Q000187:drug effects / Q000503:physiopathology; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D011247:Pregnancy; D012307:Risk Factors; D015398:Signal Transduction / Q000187:drug effects*
D000959:Antihypertensive Agents