Specialized pro-resolving mediators: key regulators in placental function and pregnancy complications

Area of Science:

• Reproductive immunology
• Lipid mediators
• Maternal-fetal medicine

Background:

• Specialized pro-resolving mediators (SPMs) are bioactive lipids essential for inflammation resolution and immune modulation.
• Healthy pregnancies involve increased SPMs, supporting tissue homeostasis and necessary inflammatory processes.
• Pregnancy complications like spontaneous abortion, fetal growth restriction (FGR), and preeclampsia are associated with disrupted SPM levels and activity.

Purpose of the Study:

• To review the role of SPMs in pregnancy, including their molecular mechanisms.
• To explore the development of targeted supplementation strategies for managing high-risk pregnancies.
• To highlight the context-dependent roles of SPMs like lipoxin A4 (LXA4) and resolvin D1 (RvD1) in placentation.

Main Methods:

• Literature review focusing on SPM roles in physiological and complicated pregnancies.
• Analysis of molecular mechanisms underlying SPM function in pregnancy.
• Evaluation of therapeutic strategies, including aspirin-triggered lipoxins and omega-3 fatty acid supplementation.

Main Results:

• Physiological pregnancies show a gradual increase in SPM levels.
• Altered SPM levels are implicated in spontaneous abortion, FGR, and preeclampsia.
• SPMs are vital for endothelial integrity and trophoblast proliferation, with reduced levels in FGR and dysregulated levels in preeclampsia.

Conclusions:

• SPMs play critical roles in maintaining pregnancy homeostasis and resolving inflammation.
• Dysregulated SPM activity contributes to major pregnancy complications.
• Targeted SPM enhancement strategies show promise for preventing adverse pregnancy outcomes, but personalized approaches are needed.