A Dormant Microbial Component in the Development of Preeclampsia

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Immunology

Background:

• Preeclampsia (PE) is a severe pregnancy complication characterized by multisystemic dysregulation, including abnormal placental invasion, anti-angiogenic responses, oxidative stress, and inflammation.
• The underlying causes of these PE-associated dysregulations have remained elusive, hindering effective treatment strategies.
• Previous understanding of PE did not fully account for the role of microbial factors in its pathogenesis.

Approach:

• This study proposes a unifying hypothesis that dormant microbial infections are the primary cause of PE and its associated pathologies.
• Evidence suggests that microbial resuscitation and growth trigger chronic inflammation and other PE sequelae.
• The research examines common infection routes (gut, oral, urinary tract) and the presence of microbes in placental tissues of PE patients.

Key Points:

• Bacterial products like lipopolysaccharide (LPS) are potent inflammagens, exacerbating the immune response in PE.
• Microbial iron requirements correlate with the iron dysregulation observed in PE.
• Proteomic biomarkers associated with PE are also elevated in response to infection, supporting an infectious link.

Conclusions:

• An infectious etiology for PE aligns with established criteria for environmental disease causation (Bradford Hill criteria).
• Recognizing PE as an infectious condition, potentially involving endotoxins, opens avenues for novel treatments, some of which have shown success.
• This perspective reframes PE, similar to how microbial infections were recognized in conditions like ulcers.