Is vascular biology in preeclampsia better?

Leslie Myatt, Rose P. Webster

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

Preeclampsia, a pregnancy-specific syndrome characterized by hypertension, proteinuria and edema, resolves on delivery of the placenta. Normal pregnancy is itself characterized by systemic inflammation, oxidative stress and alterations in levels of angiogenic factors and vascular reactivity. This is exacerbated in preeclampsia with an associated breakdown of compensatory mechanisms, eventually leading to placental and vascular dysfunction. The underlying pathology of preeclampsia is thought to be a relatively hypoxic or ischemic placenta. Both the placenta and maternal vasculatures are major sources of reactive oxygen and nitrogen species which can interact to produce peroxynitrite a powerful prooxidant that covalently modifies proteins by nitration of tyrosine residues, to possibly alter vascular function in preeclampsia. The linkage between placental hypoxia and maternal vascular dysfunction has been proposed to be via placental syncytiotrophoblast basement membranes shed by the placenta or via angiogenic factors which include soluble flt1 and endoglin secreted by the placenta that bind vascular endothelial growth factor (VEGF) and placental growth factor (PIGF) in the maternal circulation. There is also abundant evidence of altered reactivity of the maternal and placental vasculature and of the altered production of autocoids in preeclampsia. The occurrence of preeclampsia is increased in women with preexisting vascular disease and confers a long-term risk for development of cardiovascular disease. The vascular stress test of pregnancy thus identifies those women with a previously unrecognized at risk vascular system and promotes the development of preeclampsia. Preexisting maternal vascular dysfunction intensified by placental factors is possibly responsible for the individual pathologies of preeclampsia.

Original languageEnglish (US)
Pages (from-to)375-384
Number of pages10
JournalJournal of Thrombosis and Haemostasis
Volume7
Issue number3
DOIs
StatePublished - 2009
Externally publishedYes

Fingerprint

Pre-Eclampsia
Blood Vessels
Placenta
Mothers
Angiogenesis Inducing Agents
Pregnancy
Pathology
Reactive Nitrogen Species
Preexisting Condition Coverage
Peroxynitrous Acid
Trophoblasts
Exercise Test
Vascular Diseases
Proteinuria
Basement Membrane
Vascular Endothelial Growth Factor A
Tyrosine
Reactive Oxygen Species
Edema
Intercellular Signaling Peptides and Proteins

Keywords

  • Cardiovascular
  • Nitration oxidative stress
  • Preeclampsia
  • Vascular

ASJC Scopus subject areas

  • Hematology

Cite this

Is vascular biology in preeclampsia better? / Myatt, Leslie; Webster, Rose P.

In: Journal of Thrombosis and Haemostasis, Vol. 7, No. 3, 2009, p. 375-384.

Research output: Contribution to journalArticle

Myatt, Leslie ; Webster, Rose P. / Is vascular biology in preeclampsia better?. In: Journal of Thrombosis and Haemostasis. 2009 ; Vol. 7, No. 3. pp. 375-384.
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