Developing potential biomarkers for preeclampsia: Why is the current strategy failing?

Area of Science:

• Obstetrics and Gynecology
• Biomarker Discovery
• Maternal-Fetal Medicine

Background:

• Significant advancements in identifying preeclampsia biomarkers and screening strategies have occurred over the last decade.
• Numerous biochemical and biophysical markers, combined with demographic and clinical data, have been investigated for preeclampsia risk stratification.
• Despite these efforts, a universally accepted preventive therapy for preeclampsia remains elusive.

Purpose of the Study:

• To review the progress in preeclampsia biomarker identification and screening strategies.
• To discuss the limitations of current predictive biomarkers, particularly for early-onset preeclampsia.
• To explore the reasons behind the failure to translate predictive biomarker research into effective preventive therapies.

Main Methods:

• Review of existing studies on predictive biomarkers for preeclampsia.
• Analysis of biochemical markers (e.g., soluble endoglin, PP13, PlGF, VEGF, sVEGF-R1) and their performance.
• Discussion of demographic and multivariate algorithms used in risk stratification.

Main Results:

• While numerous markers have been identified, many studies still focus on single markers for early preeclampsia subtypes (approx. 20% of cases).
• The combination of markers and algorithms has not yet led to widely adopted preventive strategies.
• Pregnant women with preeclampsia still lack commonly accepted preventive therapies.

Conclusions:

• Current predictive biomarker research for preeclampsia has not yet yielded effective preventive treatments.
• The focus on early subtypes and single markers may limit the clinical utility of identified biomarkers.
• Further research and validation through large-scale randomized studies are needed to bridge the gap between prediction and prevention.