Role of chymase in preeclampsia.

Chymase is a chymotrypsin-like serine protease. It has been identified as a key angiotensin converting enzyme (ACE)-independent and endothelin converting enzyme (ECE)-independent converting enzyme that generates angiotensin II and endothelin-1 (ET-1). As an inflammatory protease, chymase participates in multiple inflammatory responses in the vasculature which drive cytokine production and adhesion molecule expression. Chymase is also involved in extracellular matrix remodeling in both vascular and non-vascular tissues. Consequently, chymase has been implicated in the pathogenesis of multiple cardiovascular, immune, and inflammatory diseases. Recent studies have shown that chymase expression and activity are increased in placental trophoblasts and in the maternal vascular endothelium in women diagnosed with preeclampsia, a hypertensive disorder in human pregnancy. The present review will address the potential roles of chymase-mediated placental and vascular dysfunction in preeclampsia. The effects of chymase on inflammatory responses associated with endothelial activation/dysfunction in preeclampsia are also discussed.