Immune Mechanisms of Vascular Disease in Preeclampsia

Preeclampsia is a multisystem vascular disorder characterized by new-onset hypertension and proteinuria after 20 weeks of gestation. Preeclampsia affects 2% to 5% of pregnancies and is a major contributor to maternal and perinatal morbidity and mortality resulting from aberrant vascular and immunologic responses. While the exact mechanisms of why preeclampsia arises remain unclear, our current understanding suggests that inadequate vascular adaptations are a contributing factor to the disease. In this review, we focus on how immune system changes affect the onset and pathogenesis of preeclampsia, specifically in the context of placental vascular development and maternal cardiovascular dysfunction. We also discuss the potential direct link in preeclampsia between immune cells, inflammation, and how they impact placental vascular remodeling and maternal cardiac dysfunction.