Translational Obstetrics Group, Department of Obstetrics and Gynecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, Victoria, 3084, Australia; Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia.
Mercy Perinatal, Mercy Hospital for Women, Victoria, Australia.
Placenta. 2019 Sep 1;84:28-31. doi: 10.1016/j.placenta.2019.02.002. Epub 2019 Feb 4.
Pregnancy complications such as fetal growth restriction and preeclampsia are diseases with limited biomarkers for prediction, and a complete lack of therapeutic options. We define placenta-enriched molecules as those that are highly expressed in the placenta relative to all other human tissues. Many exist including mRNAs, miRNAs and proteins. It is now well established that placenta-enriched mRNAs are found within the maternal circulation and are cleared rapidly after birth. Similarly, distinct clusters of miRNAs that are placenta-enriched have been identified and are measurable within the circulation. However, perhaps the most established potential diagnostics thus far are circulating placental proteins such as placental growth factor (PlGF), pregnancy associated pregnancy protein-A (PAPP-A) and soluble FMS-like tyrosine kinase 1 (sFlt-1). There has also been much interest in targeting placenta-enriched molecules as a means to treat diseases of pregnancy. We have shown promising results in targeting placenta-enriched epidermal growth factor receptor (EGFR) to treat ectopic pregnancy. Others have focused on using placenta-enriched molecules as a means of homing therapeutic-filled nanoparticles to the placenta, or to directly target sFlt-1 to improve disease outcomes. Importantly, many placenta-enriched molecules remain largely unstudied. We propose that a better understanding of their biology, and potential contribution to the pathogenesis of diseases, may yield more predictive diagnostic and therapeutic targets.
妊娠并发症，如胎儿生长受限和子痫前期，是预测标志物有限且缺乏治疗选择的疾病。我们将胎盘丰富的分子定义为在胎盘组织中相对于所有其他人体组织高度表达的分子。有许多这样的分子存在，包括 mRNAs、miRNAs 和蛋白质。现在已经证实，胎盘丰富的 mRNAs 存在于母体循环中，并在出生后迅速清除。同样，已经鉴定出并可在循环中测量到富含胎盘的独特 miRNA 簇。然而，到目前为止，最成熟的潜在诊断方法可能是循环胎盘蛋白，如胎盘生长因子 (PlGF)、妊娠相关蛋白 A (PAPP-A) 和可溶性 FMS 样酪氨酸激酶 1 (sFlt-1)。针对胎盘丰富的分子作为治疗妊娠疾病的手段也引起了广泛关注。我们已经在靶向胎盘丰富的表皮生长因子受体 (EGFR) 以治疗异位妊娠方面取得了有希望的结果。其他人则专注于利用胎盘丰富的分子作为将治疗性填充纳米颗粒归巢到胎盘的一种手段，或直接靶向 sFlt-1 以改善疾病结局。重要的是，许多胎盘丰富的分子仍在很大程度上未被研究。我们提出，更好地了解它们的生物学特性及其对疾病发病机制的潜在贡献，可能会产生更具预测性的诊断和治疗靶点。
