Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, China.
Shenzhen Huazhong University of Science and Technology Research Institute, Shenzhen, 518000, China.
Stem Cell Rev Rep. 2024 Aug;20(6):1501-1511. doi: 10.1007/s12015-024-10739-x. Epub 2024 May 30.
The placenta plays a crucial role in maintaining normal pregnancy. The failure of spiral artery remodeling (SAR) is a key factor leading to placental ischemia and poor perfusion which is strongly associated with obstetric diseases, including preeclampsia (PE) and fetal growth restriction (FGR). Existing interventions for PE and FGR are limited and termination of pregnancy is inevitable when the maternal or fetus condition deteriorates. Considering the safety of the mother and fetus, treatments that may penetrate the placental barrier and harm the fetus are not accepted. Developing targeted treatment strategies for these conditions is urgent and necessary. With the proven efficacy of targeted therapy in treating conditions such as endometrial cancer and trophoblastic tumors, research on placental dysfunction continues to deepen. This article reviews the studies on placenta-targeted treatment and drug delivery strategies, summarizes the characteristics proposes corresponding improvement measures in targeted treatment, provides solutions for existing problems, and makes suggestions for future studies.
胎盘在维持正常妊娠中起着至关重要的作用。螺旋动脉重塑（SAR）的失败是导致胎盘缺血和灌注不良的关键因素，这与包括子痫前期（PE）和胎儿生长受限（FGR）在内的产科疾病密切相关。现有的 PE 和 FGR 干预措施有限，当母体或胎儿情况恶化时，终止妊娠是不可避免的。考虑到母婴的安全，那些可能穿透胎盘屏障并伤害胎儿的治疗方法是不可接受的。因此，针对这些疾病开发靶向治疗策略是紧急和必要的。由于靶向治疗在治疗子宫内膜癌和滋养细胞肿瘤等疾病方面已被证实具有疗效，因此对胎盘功能障碍的研究也在不断深入。本文综述了胎盘靶向治疗和药物传递策略的研究，总结了靶向治疗的特点，提出了相应的改进措施，为解决现有问题提供了方案，并对未来的研究提出了建议。
