Exosome Biology Laboratory, Centre for Clinical Diagnostics, University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital, The University of Queensland, Brisbane, QLD 4029, Australia.
Departments of Comparative Biosciences and Obstetrics and Gynecology, University of Wisconsin, Madison, WI 53792, USA.
Int J Mol Sci. 2019 Sep 5;20(18):4370. doi: 10.3390/ijms20184370.
Uncomplicated healthy pregnancy is the outcome of successful fertilization, implantation of embryos, trophoblast development and adequate placentation. Any deviation in these cascades of events may lead to complicated pregnancies such as preeclampsia (PE). The current incidence of PE is 2-8% in all pregnancies worldwide, leading to high maternal as well as perinatal mortality and morbidity rates. A number of randomized controlled clinical trials observed the association between low dose aspirin (LDA) treatment in early gestational age and significant reduction of early onset of PE in high-risk pregnant women. However, a substantial knowledge gap exists in identifying the particular mechanism of action of aspirin on placental function. It is already established that the placental-derived exosomes (PdE) are present in the maternal circulation from 6 weeks of gestation, and exosomes contain bioactive molecules such as proteins, lipids and RNA that are a "fingerprint" of their originating cells. Interestingly, levels of exosomes are higher in PE compared to normal pregnancies, and changes in the level of PdE during the first trimester may be used to classify women at risk for developing PE. The aim of this review is to discuss the mechanisms of action of LDA on placental and maternal physiological systems including the role of PdE in these phenomena. This review article will contribute to the in-depth understanding of LDA-induced PE prevention.
正常妊娠是成功受精、胚胎着床、滋养细胞发育和充分胎盘形成的结果。这些事件链中的任何偏差都可能导致复杂的妊娠，如子痫前期 (PE)。目前，PE 在全球所有妊娠中的发病率为 2-8%，导致孕产妇和围产儿死亡率和发病率居高不下。许多随机对照临床试验观察到，在早孕时使用低剂量阿司匹林 (LDA) 治疗与高危孕妇的早发型 PE 发生率显著降低有关。然而，在确定阿司匹林对胎盘功能的特定作用机制方面仍存在相当大的知识差距。已经确定胎盘来源的外泌体 (PdE) 从妊娠 6 周开始存在于母体循环中，外泌体包含生物活性分子，如蛋白质、脂质和 RNA，它们是其来源细胞的“指纹”。有趣的是，与正常妊娠相比，PE 中外泌体的水平更高，并且在孕早期 PdE 水平的变化可用于对发生 PE 的高危妇女进行分类。本综述的目的是讨论 LDA 对胎盘和母体生理系统的作用机制，包括 PdE 在这些现象中的作用。这篇综述文章将有助于深入了解 LDA 诱导的 PE 预防。
