title: Biochemistry of HELLP syndrome.
abstract: The HELLP syndrome is a serious complication of pregnancy characterized by hemolysis (H), elevated liver (EL) enzymes, and low platelet (LP) count that occurs in 0.2-0.6% of all pregnancies and in 10-20% of cases with severe preeclampsia and frequently leads to adverse maternal and perinatal outcome. The exact pathobiology of HELLP syndrome has not been clearly defined. As it is considered a form or a complication of severe preeclampsia, it likely has its origin in aberrant placental development and function resulting in ischemia-producing oxidative stress. However, there is still a debate on whether HELLP must be considered a severe form of preeclampsia or a separate disease entity. It can be described as a placenta-induced disease, as is preeclampsia itself, but with a more acute and predominant inflammatory process typically targeting the liver and with a greater activation of the coagulation system. This occurs during a disordered immunologic process and may be due to a genetic predisposition. In this review, we discuss the main biochemical characteristics of HELLP syndrome, particularly focusing on molecular aspects of placental involvement and maternal systemic responses.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Torino, Torino, Italy. chbened@tin.it
authors.forename: Chiara
authors.initials: C
authors.lastname: Benedetto
authors.forename: Luca
authors.initials: L
authors.lastname: Marozio
authors.forename: Annalisa
authors.initials: A
authors.lastname: Tancredi
authors.forename: Elisa
authors.initials: E
authors.lastname: Picardo
authors.forename: Paola
authors.initials: P
authors.lastname: Nardolillo
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Tavella
authors.forename: Loredana
authors.initials: L
authors.lastname: Salton
mesh_terms: D001777:Blood Coagulation; D003165:Complement System Proteins / Q000502:physiology; D005260:Female; D017359:HELLP Syndrome / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000209:etiology; D010920:Placenta / Q000502:physiology; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy
chemical_list: D003165:Complement System Proteins