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Updated: Jul 10, 2025
Author Spotlight: Modeling an Aspect of Preeclampsia in Female Mice Using Hypoxic Human Placenta-Derived Small Extracellular Vesicles
Published on: January 26, 2024
Early prediction of pre-eclampsia using circulating placental exosomes: Newer insights
Aishwarya Rao1, Uma Shinde2, Dhanjit Kumar Das3
1Department of Innate Immunity, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, Maharashtra, India.
Insights
Early prediction of pre-eclampsia (PE) is challenging. Monitoring placental exosomes (pEXO) in maternal circulation offers a promising, non-invasive approach for identifying predictive biomarkers for this pregnancy disorder.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Biomarker Discovery
Background:
- Pre-eclampsia (PE) is a major cause of pregnancy complications, with current prediction methods being inadequate.
- Existing serum biomarkers for PE lack the necessary specificity and consistency for early detection.
- Direct placental assessment is not feasible during pregnancy, necessitating alternative diagnostic strategies.
Approach:
- This review examines circulating placental exosomes (pEXO) as non-invasive surrogates for placental biomarkers.
- Investigates the potential of pEXO molecular signatures for early PE prediction.
- Summarizes current literature on candidate circulating biomarkers for PE.
Key Points:
- Placental exosomes (pEXO) are present in maternal circulation from early gestation and reflect placental status.
- Distinct molecular profiles within pEXO may serve as early indicators of pre-eclampsia.
- pEXO offer a viable alternative to invasive placental sampling for biomarker discovery.
Conclusions:
- Monitoring changes in placental exosome expression profiles can provide crucial insights into PE.
- Identifying novel pEXO-based biomarkers is essential for timely PE diagnosis and management.
- Further research into pEXO signatures holds promise for improving prediction and intervention strategies for pre-eclampsia.
Abstract:
Pre-eclampsia (PE), a multifactorial de novo hypertensive pregnancy disorder, is one of the leading causes of foeto-maternal morbidity and mortality. Currently, antihypertensive drugs are the first-line therapy for PE and evidence suggests that low-dose aspirin initiated early in high risk pregnancies may reduce the risk of development or severity of PE. However, an early prediction of this disorder remains an unmet clinical challenge. Several potential serum biomarkers associated with maternal immunoregulation and placental angiogenesis have been evaluated but are ineffective and inconsistent for early prediction. Although placental biomarkers would be more specific and sensitive in predicting the risk of PE, accessing the placenta during pregnancy is not feasible. Circulating placental exosomes (pEXO), originating from foeto-maternal interface, are being evaluated as the placenta's surrogate and the best source of non-invasive placental biomarkers. pEXO appear in the maternal circulation starting from six weeks of gestation and its dynamic biological cargo across pregnancy is associated with successful pregnancy outcomes. Therefore, monitoring changes in pEXO expression profiles could provide new insights into the prediction, diagnosis and treatment of PE. This narrative review comprehensively summarizes the available literature on the candidate predictive circulating biomarkers evaluated for PE to date. In particular, the review elucidates the current knowledge of distinct molecular signatures emanating from pEXO in pre-eclamptic women to support the discovery of novel early predictive biomarkers for effective intervention and management of the disease.
