Lin Saunders, Leonard Dean, Co Mary A M, Mukhopadhyay Dhriti, Giri Badri, Perger Lena, Beeram Madhava R, Kuehl Thomas J, Uddin Mohammad N
Texas A&M University College of Medicine, Temple, Tex.
Prehealth Studies, Baylor University, Waco, Tex.
Transl Res. 2015 Apr;165(4):449-63. doi: 10.1016/j.trsl.2014.10.006. Epub 2014 Oct 16.
Pre-eclampsia (preE) is a multifaceted complication found uniquely in the pregnant patient and one that has puzzled scientists for years. PreE is not a single disorder, but a complex syndrome that is produced by various pathophysiological triggers and mechanisms affecting about 5% of obstetrical patients. PreE is a major cause of premature delivery and maternal and fetal morbidity and mortality. PreE is characterized by de novo development of hypertension and proteinuria after 20 weeks of gestation and affects nearly every organ system, with the most severe consequences being eclampsia, pulmonary edema, intrauterine growth restriction, and thrombocytopenia. PreE alters the intrauterine environment by modulating the pattern of hormonal signals and activating the detrimental cellular signaling that has been transported to the fetus. The fetus has to adapt to this intrauterine environment with detrimental signals. The adaptive changes increase the risk of disease later in life. This review defines the predisposition and causes of preE and the cellular signaling detrimental to maternal health during preE. Moreover, the risk factors for diseases that are transmitted to the offspring have been addressed in this review. The detrimental signaling molecules that have been overexpressed in preE patients raises the possibility that those signals could be therapeutically blocked one day.
子痫前期（preE）是一种仅在孕妇中出现的多方面并发症，多年来一直困扰着科学家。子痫前期不是单一疾病，而是一种复杂综合征，由多种病理生理触发因素和机制引起，影响约5%的产科患者。子痫前期是早产以及母婴发病和死亡的主要原因。子痫前期的特征是妊娠20周后新发高血压和蛋白尿，几乎影响每个器官系统，最严重的后果是子痫、肺水肿、胎儿生长受限和血小板减少。子痫前期通过调节激素信号模式和激活已传递给胎儿的有害细胞信号来改变子宫内环境。胎儿必须适应这种带有有害信号的子宫内环境。这些适应性变化会增加日后患疾病的风险。本综述定义了子痫前期的易感性和病因以及子痫前期期间对母体健康有害的细胞信号。此外，本综述还探讨了传递给后代的疾病的危险因素。子痫前期患者中过度表达的有害信号分子增加了这些信号有朝一日可能被治疗性阻断的可能性。
