Department of Pathology and Medical Biology, Pathology Section, University of Groningen, University Medical Center Groningen, The Netherlands.
Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, The Netherlands.
Placenta. 2018 Sep;69:153-161. doi: 10.1016/j.placenta.2018.03.003. Epub 2018 Mar 16.
The most important function of the placenta is the exchange of nutrients and oxygen between a mother and her fetus. To establish a healthy functioning placenta, placentation needs to occur with adequate remodelling of spiral arteries by extravillous trophoblasts. When this process is impaired, the resulting suboptimal and inadequate placenta function results in the manifestation of pregnancy complications. Impaired placenta function can cause preeclampsia and leads to fetal growth restriction due to hypoxia. Presence of hypoxia leads to oxidative stress due to an imbalance between reactive oxygen species and antioxidants, thereby causing damage to proteins, lipids and DNA. In the placenta, signs of morphological adaptation in response to hypoxia can be found. Different placental lesions like maternal or fetal vascular malperfusion or chronic villitis lead to a decreased exchange of oxygen between the mother and the fetus. Clinically, several biomarkers indicative for oxidative stress, e.g. malondialdehyde and reduced levels of free thiols are found. This review aims to give an overview of the causes and (potential) role of placental oxidative stress in the development of placental parenchymal pathology and its clinical consequences. Also, therapeutic options aiming at prevention or treatment of hypoxia of the placenta and fetus are described.
胎盘最重要的功能是在母亲和胎儿之间交换营养物质和氧气。为了建立一个健康的胎盘功能，胎盘需要通过绒毛外滋养细胞对螺旋动脉进行充分的重塑。当这个过程受损时，由此产生的次优和不足的胎盘功能会导致妊娠并发症的发生。胎盘功能受损会导致子痫前期，并由于缺氧导致胎儿生长受限。缺氧会导致氧化应激，因为活性氧和抗氧化剂之间的平衡被打破，从而导致蛋白质、脂质和 DNA 的损伤。在胎盘，可以发现对缺氧的形态适应迹象。不同的胎盘病变，如母体或胎儿血管灌注不良或慢性绒毛膜炎，会导致母亲和胎儿之间氧气交换减少。临床上，可以发现几种表明氧化应激的生物标志物，例如丙二醛和游离巯基水平降低。本综述旨在概述胎盘氧化应激在胎盘实质病变发展及其临床后果中的原因和（潜在）作用。还描述了旨在预防或治疗胎盘和胎儿缺氧的治疗选择。
