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Updated: Dec 7, 2025
Comprehensive Evaluation of the Effectiveness and Safety of Placenta-Targeted Drug Delivery Using Three Complementary Methods
Published on: September 10, 2018
Novel approaches to combat preeclampsia: from new drugs to innovative delivery
Natasha de Alwis1, Natalie K Binder1, Sally Beard1
1Therapeutics Discovery and Vascular Function, Australia; Translational Obstetrics Group, Department of Obstetrics and Gynaecology, University of Melbourne, Australia; Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
Abstract:
Preeclampsia is a complex disease affecting 2-8% of pregnancies worldwide. It poses significant risk of maternal and perinatal morbidity and mortality. Despite the rising research interest to discover new therapeutic approaches to prevent and treat preeclampsia, options remain limited. Identifying the important pathological stages in the progression of this disease allows us to evaluate effective candidate therapeutics. Three important stages in the pathophysiology are: 1) placental hypoxia and oxidative stress, 2) excess release of anti-angiogenic and pro-inflammatory factors, and 3) widespread systemic endothelial dysfunction and vasoconstriction. Repurposing drugs already safe for use in pregnancy is an attractive option for discovery of novel therapeutics. There are many drugs currently being assessed to treat preeclampsia, including proton pump inhibitors (PPIs), metformin, statins, sulfasalazine, sofalcone, resveratrol, melatonin, and sildenafil citrate. These drugs show positive effects in preclinical studies, targeting placental and endothelial dysfunction. However, using novel therapeutics can raise safety concerns for the developing fetus. Therefore, innovative targeted delivery systems are being developed to safely administer these therapeutics directly to the placenta and/or endothelium. These include nanoparticle delivery systems, developed and used by the oncology field, now being adapted for obstetrics. This technology is currently being assessed in animal models and shows promise for treating preeclampsia. Combining effective therapeutics with targeted drug delivery could be the future of preeclampsia treatment.
Insights
Preeclampsia treatments are limited, but repurposing existing drugs and using nanoparticle delivery systems show promise for improving maternal and fetal outcomes in pregnancies affected by this condition.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Pharmacology
Background:
- Preeclampsia affects 2-8% of pregnancies globally, leading to significant maternal and perinatal risks.
- Current therapeutic options for preeclampsia are limited despite ongoing research.
- Understanding preeclampsia's pathophysiology, including placental hypoxia, inflammation, and endothelial dysfunction, is key to developing new treatments.
Purpose of the Study:
- To review current research on novel therapeutic approaches for preeclampsia.
- To explore drug repurposing and targeted delivery systems as potential treatment strategies.
- To identify promising candidate therapeutics and delivery methods for preeclampsia.
Main Methods:
- Literature review of preclinical studies on drug repurposing for preeclampsia.
- Analysis of emerging targeted drug delivery systems, such as nanoparticles.
- Evaluation of drugs including proton pump inhibitors, metformin, statins, and others.
Main Results:
- Several repurposed drugs demonstrate efficacy in preclinical models by targeting placental and endothelial dysfunction.
- Nanoparticle delivery systems show promise for safe and targeted administration of therapeutics to the placenta and endothelium.
- Combining effective therapeutics with targeted delivery may offer a future treatment paradigm.
Conclusions:
- Drug repurposing presents an attractive strategy for novel preeclampsia therapeutics due to existing safety profiles.
- Targeted drug delivery systems, like nanoparticles, address safety concerns for the fetus.
- The combination of effective drugs and targeted delivery holds significant potential for future preeclampsia management.
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