O'Tierney-Ginn Perrie F, Lash Gendie E
Center for Reproductive Health, MetroHealth Medical Center at Case Western Reserve U, Cleveland, OH, USA.
Reproductive and Vascular Biology Group, Institute of Cellular Medicine, Newcastle University, USA.
J Reprod Immunol. 2014 Oct;104-105:37-42. doi: 10.1016/j.jri.2014.04.002. Epub 2014 May 12.
Invasion of extravillous trophoblast cells (EVTs) into the maternal tissues is a key step in the development of a successful pregnancy, excessive and insufficient EVT invasion being associated with pregnancy complications. These pregnancy complications include preeclampsia and fetal growth restriction, both of which are associated with maternal and fetal morbidity and mortality at the time of birth and with increased risk of cardiovascular disease, diabetes and obesity in adult life for infants born from these conditions. In addition, women who develop preeclampsia are also at a greater risk of cardiovascular disease in later life. Many factors, protein and environmental, have been shown to both up- and down-regulate this process in vitro via different mechanisms. The redundancy observed in the regulation of this system suggests that dysregulation of one factor may not contribute to the pathological conditions of EVT invasion and that the relative local concentrations of many different factors may be more important. This review article explores the possibility that the modulation of EVT invasion as a therapeutic target for pregnancies affected by preeclampsia and fetal growth restriction may not be possible or needs to concentrate on the modulation of cell activity as a whole and not of one particular factor.
绒毛外滋养层细胞（EVTs）侵入母体组织是成功妊娠发育的关键步骤，EVT侵入过多或不足都与妊娠并发症有关。这些妊娠并发症包括子痫前期和胎儿生长受限，二者都与出生时母婴的发病率和死亡率相关，并且对于在这些情况下出生的婴儿，成年后患心血管疾病、糖尿病和肥胖症的风险也会增加。此外，患子痫前期的女性在晚年患心血管疾病的风险也更高。许多因素，包括蛋白质和环境因素，已被证明在体外通过不同机制上调和下调这一过程。在该系统调节中观察到的冗余表明，单一因素的失调可能不会导致EVT侵入的病理状况，许多不同因素的相对局部浓度可能更为重要。这篇综述文章探讨了这样一种可能性，即对于受子痫前期和胎儿生长受限影响的妊娠，将调节EVT侵入作为治疗靶点可能不可行，或者需要专注于整体调节细胞活性而非某一特定因素。
