Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Carmen Sylva 2444, Santiago 7510156, Chile.
Biomedical Research Centre, School of Medicine, Universidad de Valparaíso, Viña Del Mar 2540064, Chile; MSc. (C) in the Program Magíster en Ciencias Médicas con Mención en Biología Celular y Molecular. Universidad de Valparaíso, Chile.
Placenta. 2021 Sep 15;113:57-66. doi: 10.1016/j.placenta.2021.05.002. Epub 2021 May 21.
Preeclampsia is a pregnancy-specific syndrome characterized by a sudden increase in blood pressure accompanied by proteinuria and/or maternal multi-system damage associated to poor fetal outcome. In early-onset preeclampsia, utero-placental perfusion is altered, causing constant and progressive damage to the syncytiotrophoblast, generating syncytiotrophoblast stress. The latter leads to the detachment and release of syncytiotrophoblast fragments, anti-angiogenic factors and pro-inflammatory molecules into maternal circulation, resulting in the emergence and persistence of the characteristic symptoms of this syndrome during pregnancy. Therefore, understanding the origin and consequences of syncytiotrophoblast stress in preeclampsia is vital to develop new therapeutic alternatives, focused on reducing the burden of this syndrome. In this review, we describe five central characteristics of syncytial stress that should be targeted or prevented in order to reduce preeclampsia symptoms: histological alterations, syncytiotrophoblast damage, antiangiogenic protein export, placental deportation, and altered syncytiotrophoblast turnover. Therapeutic management of these characteristics may improve maternal and fetal outcomes.
子痫前期是一种妊娠特有的综合征，其特征是血压突然升高，伴有蛋白尿和/或母体多系统损伤，与不良胎儿结局相关。在早发型子痫前期中，子宫胎盘灌注发生改变，导致合体滋养层持续进行性损伤，产生合体滋养层应激。后者导致合体滋养层碎片、抗血管生成因子和促炎分子脱落并释放到母体循环中，导致妊娠期间该综合征特征性症状的出现和持续存在。因此，了解子痫前期中合体滋养层应激的起源和后果对于开发新的治疗方法至关重要，这些方法的重点是减轻该综合征的负担。在这篇综述中，我们描述了五种需要针对或预防的合体滋养层应激的核心特征，以减轻子痫前期的症状：组织学改变、合体滋养层损伤、抗血管生成蛋白外排、胎盘转移和合体滋养层更新改变。这些特征的治疗管理可能会改善母婴结局。
