Nitric oxide signaling in pregnancy and preeclampsia

While the etiology of preeclampsia continues to be elucidated, it is clear that preeclampsia is a complex obstetrical syndrome associated with maternal vascular dysfunction within which impairments in nitric oxide (NO) signaling likely play a key role in driving disease progression and severity. The goal of this review is to present the available evidence for maladaptations in NO and NO signaling in pregnancies complicated by preeclampsia. After a brief overview of preeclampsia, a review of the available evidence for NO and NO signaling adaptations in normal, uncomplicated pregnancy is given to lay a foundation for changes driven by preeclampsia. Next, current evidence for maladaptations of NO and NO signaling in preeclampsia is reviewed. Finally, a brief summary of NO-focused treatments for preeclampsia prevention is discussed. Considering preeclampsia is a syndrome solely occurring among pregnant women, this review focuses on NO signaling in clinical studies, with supplementary evidence from animal studies added when necessary.