From placenta to podocyte: Vascular and podocyte pathophysiology in preeclampsia

Steven J. Wagner, Iasmina M. Craici, Joseph Peter Grande, Vesna D Garovic

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Preeclampsia is a disorder of hypertension and proteinuria that affects 6-8% of normal pregnancies. Recent research has revealed many molecular mechanisms that may contribute to systemic endothelial dysfunction, glomerular capillary endotheliosis, dysregulation of the glomerular filtration apparatus, and podocyte loss. An ischemic placenta elaborates soluble FMS-like tyrosine kinase 1 (sFlt-1), a soluble receptor for vascular endothelial growth factor (VEGF). A variety of mediators, including nitric oxide, Angiotensin II receptor autoantibodies (AT1AA), and endothelin-1 may serve to maintain placental ischemia and systemic endothelial dysfunction. Endothelin-1 and decreased vascular endothelial growth factor may adversely affect overall expression and distribution of podocyte foot process proteins, leading to proteinuria. Podocyte derangements may lead to podocyte apoptosis and loss, as evidenced by the detection of live podocytes and podocyte products in the urine of preeclamptic women. In this review, we explore recent research elucidating the interactions of placenta, endothelium, and podocyte leading to the clinical syndrome of preeclampsia.

Original languageEnglish (US)
Pages (from-to)241-249
Number of pages9
JournalClinical Nephrology
Volume78
Issue number3
DOIs
StatePublished - Sep 2012

Fingerprint

Podocytes
Pre-Eclampsia
Placenta
Blood Vessels
Endothelin-1
Proteinuria
Vascular Endothelial Growth Factor Receptor
Angiotensin Receptors
Research
Autoantibodies
Protein-Tyrosine Kinases
Vascular Endothelial Growth Factor A
Endothelium
Nitric Oxide
Ischemia
Urine
Apoptosis
Hypertension
Pregnancy

Keywords

  • Endothelium
  • Placenta
  • Podocyte
  • Podocyturia
  • Preeclampsia

ASJC Scopus subject areas

  • Nephrology

Cite this

From placenta to podocyte : Vascular and podocyte pathophysiology in preeclampsia. / Wagner, Steven J.; Craici, Iasmina M.; Grande, Joseph Peter; Garovic, Vesna D.

In: Clinical Nephrology, Vol. 78, No. 3, 09.2012, p. 241-249.

Research output: Contribution to journalArticle

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