Tracking placental development in health and disease.
Biomarkers
Decidua
/ physiopathology
Embryonic Development
Endometrium
/ physiopathology
Female
Fetal Development
Fetal Growth Retardation
/ physiopathology
Fetus
/ blood supply
Humans
Placenta
/ blood supply
Placenta Diseases
/ physiopathology
Placentation
/ physiology
Pre-Eclampsia
/ physiopathology
Pregnancy
Pregnancy Complications
/ physiopathology
Signal Transduction
Trophoblasts
/ physiology
Journal
Nature reviews. Endocrinology
ISSN: 1759-5037
Titre abrégé: Nat Rev Endocrinol
Pays: England
ID NLM: 101500078
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
accepted:
15
05
2020
pubmed:
1
7
2020
medline:
9
10
2020
entrez:
1
7
2020
Statut:
ppublish
Résumé
Pre-eclampsia and fetal growth restriction arise from disorders of placental development and have some shared mechanistic features. Initiation is often rooted in the maldevelopment of a maternal-placental blood supply capable of providing for the growth requirements of the fetus in later pregnancy, without exerting undue stress on maternal body systems. Here, we review normal development of a placental bed with a safe and adequate blood supply and a villous placenta-blood interface from which nutrients and oxygen can be extracted for the growing fetus. We consider disease mechanisms that are intrinsic to the maternal environment, the placenta or the interaction between the two. Systemic signalling from the endocrine placenta targets the maternal endothelium and multiple organs to adjust metabolism for an optimal pregnancy and later lactation. This signalling capacity is skewed when placental damage occurs and can deliver a dangerous pathogenic stimulus. We discuss the placental secretome including glycoproteins, microRNAs and extracellular vesicles as potential biomarkers of disease. Angiomodulatory mediators, currently the only effective biomarkers, are discussed alongside non-invasive imaging approaches to the prediction of disease risk. Identifying the signs of impending pathology early enough to intervene and ameliorate disease in later pregnancy remains a complex and challenging objective.
Identifiants
pubmed: 32601352
doi: 10.1038/s41574-020-0372-6
pii: 10.1038/s41574-020-0372-6
doi:
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
479-494Références
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