Liu Nan, Guo Yu-Na, Gong Li-Kun, Wang Bing-Shun
School of Pharmacy, University of Chinese Academy of Sciences, Beijing, 100049, China.
State Key Laboratory of Drug Research, Center for Drug Safety Evaluation and Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
Eur J Obstet Gynecol Reprod Biol X. 2020 Oct 9;9:100119. doi: 10.1016/j.eurox.2020.100119. eCollection 2021 Jan.
Preeclampsia (PE) is a pregnancy-specific complication that seriously threatens the health and safety of mothers and infants. The etiology of PE has not been fully elucidated, and no effective treatments are currently available. A pregnant woman with PE often has to make a tough choice on either endangering her own health to give a birth or being forced to terminate her pregnancy. It is recommended by the International Federation of Gynecology and Obstetrics that the combination of maternal high-risk factors and biomarkers could form a good strategy for predicting the risk of PE. Such a combination may also enable more effective monitoring and early clinical intervention in high-risk populations to reduce the risk of PE. Therefore, biomarkers validated by extensive clinical research may be formally applied for clinical PE risk prediction. In this review, we summarized data from clinical research on potential biomarkers and classified them according to the current four major hypotheses, namely placental or trophoblast ischemia and hypoxia, vascular endothelial injury, oxidative stress, and immune dysregulation. Additionally, we also discussed the underlying mechanisms by which these potential biomarkers may be involved in the pathogenesis of PE. Finally, we propose that multiple biomarkers reflecting different aspects of the disease pathogenesis should be used in combination to detect the high-risk PE population in support of clinically targeted intervention and prevention of PE. It is expected that tests made of more sensitive and reliable PE biomarkers based on the aforementioned major hypotheses could potentially improve the accuracy of PE prediction in the future.
子痫前期（PE）是一种特定于妊娠的并发症，严重威胁母婴的健康与安全。PE的病因尚未完全阐明，目前也没有有效的治疗方法。患有PE的孕妇常常不得不面临艰难抉择：要么冒着自身健康风险分娩，要么被迫终止妊娠。国际妇产科联合会建议，将孕产妇高危因素与生物标志物相结合，可能构成预测PE风险的良好策略。这种组合还可能有助于对高危人群进行更有效的监测和早期临床干预，以降低PE风险。因此，经过广泛临床研究验证的生物标志物可能会正式应用于临床PE风险预测。在本综述中，我们总结了关于潜在生物标志物的临床研究数据，并根据目前的四个主要假说对其进行分类，即胎盘或滋养层缺血缺氧、血管内皮损伤、氧化应激和免疫失调。此外，我们还讨论了这些潜在生物标志物可能参与PE发病机制的潜在机制。最后，我们建议应联合使用反映疾病发病机制不同方面的多种生物标志物，以检测高危PE人群，支持对PE进行临床靶向干预和预防。预计基于上述主要假说开发的更敏感、可靠的PE生物标志物检测方法，未来可能会提高PE预测的准确性。
