Understanding Preeclampsia: Integrating Placental Dysfunction, Immune Dysregulation and microRNA-Mediated Epigenetic...

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Immunology

Background:

• Preeclampsia is a significant global cause of maternal and perinatal morbidity and mortality.
• It is a pregnancy-specific multisystem disorder with complex pathophysiological mechanisms.
• Current understanding involves a two-stage model initiated by placental dysfunction.

Purpose of the Study:

• To review current evidence on preeclampsia risk factors and pathophysiological mechanisms.
• To highlight the roles of angiogenic imbalance, immune dysregulation, and inflammation.
• To emphasize the contribution of maternal factors and microRNAs.

Main Methods:

• This is a narrative review of existing scientific literature.
• Evidence on principal risk factors and pathophysiological mechanisms was summarized.
• Emphasis was placed on maternal risk factors and molecular contributions.

Main Results:

• Preeclampsia development involves placental hypoperfusion, hypoxia, and oxidative stress (Stage 1).
• The hypoxic placenta releases factors like sFlt-1 and sEng, causing endothelial dysfunction (Stage 2).
• Key factors include angiogenic imbalance, immune dysregulation, inflammation, maternal risks, and microRNAs.

Conclusions:

• Understanding preeclampsia's interconnected mechanisms is crucial for improved diagnosis and risk stratification.
• Targeted preventive and therapeutic strategies may be developed based on this knowledge.
• Further research into immune cells (Th1/Th2/Th17/Treg, NK cells) and microRNAs is warranted.