title: Placental protein 13 (PP13): a new biological target shifting individualized risk assessment to personalized drug design combating pre-eclampsia.
abstract: BACKGROUND
  Pre-eclampsia affects 2-7% of all pregnant women and is a major cause of maternal and fetal morbidity and mortality. The etiology of pre-eclampsia is still unknown but it is well documented that impaired placentation is a major contributor to its development. One of the placenta-specific proteins is placental protein 13 (PP13). Lower first trimester levels of maternal serum PP13 and its encoding placental mRNA are associated with the development of both early and late-onset severe pre-eclampsia. In cases where this protein is mutated, the frequency of pre-eclampsia is higher.
  
  
  METHODS
  19 out of 68 studies on PP13, published between January 2006 and September 2012, were used to evaluate the value of maternal blood PP13 as a marker of pre-eclampsia.
  
  
  RESULTS
  A meta-analysis presented in this review shows that low serum levels of PP13 in the first trimester of pregnancy can predict the development of pre-eclampsia later in pregnancy. Although some functions of this protein have been assessed in in vitro experiments, the in vivo functions of PP13 are still unknown, especially when circulating in the maternal bloodstream. A recent pilot study has shown that in gravid rats PP13 causes significant vasodilatation, reduced blood pressure and increased maternal uterine artery remodeling.
  
  
  CONCLUSIONS
  Reviewing these effects of PP13, the authors propose the use of PP13 as a new drug candidate. Replenishing PP13 in those women with low serum levels early in pregnancy may help prepare their vasculature for pregnancy. This novel pharmacological approach to combat pre-eclampsia is presented as a new direction to transfer from individualized risk to personalized prevention.
authors: Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Harrachgasse 21/7, Graz 8010, Austria. berthold.huppertz@medunigraz.at
authors: Berthold
authors: B
authors: Huppertz
authors: Hamutal
authors: H
authors: Meiri
authors: Sveinbjorn
authors: S
authors: Gizurarson
authors: George
authors: G
authors: Osol
authors: Marei
authors: M
authors: Sammar
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D015195:Drug Design; D005260:Female; D037161:Galectins / Q000097:blood / Q000378:metabolism*; D006801:Humans; D010865:Pilot Projects; D010920:Placenta / Q000378:metabolism; D010929:Placentation; D011225:Pre-Eclampsia / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D057285:Precision Medicine; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood / Q000378:metabolism*; D011261:Pregnancy Trimester, First; D051381:Rats; D018570:Risk Assessment; D055988:Uterine Artery
chemical_list: D015415:Biomarkers; D037161:Galectins; C038195:LGALS13 protein, human; D011257:Pregnancy Proteins
keywords: LGALS13; PP13; galectins; personalized medicine; placenta