Advances in the pathophysiology of pre-eclampsia and related podocyte injury

Iasmina M. Craici, Steven J. Wagner, Tracey L. Weissgerber, Joseph P. Grande, Vesna D. Garovic

Research output: Contribution to journalReview article

60 Scopus citations

Abstract

Pre-eclampsia is a pregnancy-specific hypertensive disorder that may lead to serious maternal and fetal complications. It is a multisystem disease that is commonly, but not always, accompanied by proteinuria. Its cause(s) remain unknown, and delivery remains the only definitive treatment. It is increasingly recognized that many pathophysiological processes contribute to this syndrome, with different signaling pathways converging at the point of systemic endothelial dysfunction, hypertension, and proteinuria. Different animal models of pre-eclampsia have proven utility for specific aspects of pre-eclampsia research, and offer insights into pathophysiology and treatment possibilities. Therapeutic interventions that specifically target these pathways may optimize pre-eclampsia management and may improve fetal and maternal outcomes. In addition, recent findings regarding placental, endothelial, and podocyte pathophysiology in pre-eclampsia provide unique and exciting possibilities for improved diagnostic accuracy. Emerging evidence suggests that testing for urinary podocytes or their markers may facilitate the prediction and diagnosis of pre-eclampsia. In this review, we explore recent research regarding placental, endothelial, and podocyte pathophysiology. We further discuss new signaling and genetic pathways that may contribute to pre-eclampsia pathophysiology, emerging screening and diagnostic strategies, and potential targeted interventions.

Original languageEnglish (US)
Pages (from-to)275-285
Number of pages11
JournalKidney international
Volume86
Issue number2
DOIs
StatePublished - Aug 2014

Keywords

  • endothelial dysfunction
  • placenta
  • podocyturia
  • pre-eclampsia

ASJC Scopus subject areas

  • Nephrology

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