Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, Kasprzaka 17a, 01-211 Warsaw, Poland.
Department of Cardiology, Institute of Mother and Child in Warsaw, Kasprzaka 17a, 01-211 Warsaw, Poland.
Int J Mol Sci. 2021 Mar 19;22(6):3132. doi: 10.3390/ijms22063132.
Preeclampsia affects about 3-8% of all pregnancies. It represents a complex and multifaceted syndrome with at least several potential pathways leading to the development of disease. The main dogma in preeclampsia is the two-stage model of disease. Stage 1 (placental stage) takes place in early pregnancy and is thought to be impaired placentation due to inadequate trophoblastic invasion of the maternal spiral arteries that leads to reduced placental perfusion and release of numerous biological factors causing endothelial damage and development of acute maternal syndrome with systemic multiorgan failure (stage 2-the onset of maternal clinical symptoms, maternal stage). Recently, in the light of the vast body of evidence, two-stage model of preeclampsia has been updated with a few novel pathways leading to clinical manifestation in the second part of pregnancy. This paper reviews current state of knowledge about pathophysiology of preeclampsia and places particular focus on the recent advances in understanding of uterine artery remodeling alterations, as well as the role of microRNAs in preeclampsia.
子痫前期影响所有妊娠的 3-8%左右。它代表了一种复杂且多方面的综合征，至少有几种潜在的途径导致疾病的发展。子痫前期的主要教条是疾病的两阶段模型。第 1 阶段（胎盘阶段）发生在妊娠早期，被认为是由于滋养细胞侵入母体螺旋动脉不足导致胎盘灌注减少，并释放出许多生物因子，导致内皮损伤和急性母体综合征的发展，伴有全身多器官衰竭（第 2 阶段-母体临床症状的出现，母体阶段）。最近，根据大量证据，子痫前期的两阶段模型已经更新，增加了一些新的途径，导致妊娠后半期的临床表现。本文综述了子痫前期病理生理学的现有知识，并特别关注对子宫动脉重塑改变的理解以及 microRNAs 在子痫前期中的作用的最新进展。
