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2016 ; 311
(1
): R1-9
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Identifying immune mechanisms mediating the hypertension during preeclampsia
#MMPMID27097659
LaMarca B
; Cornelius DC
; Harmon AC
; Amaral LM
; Cunningham MW
; Faulkner JL
; Wallace K
Am J Physiol Regul Integr Comp Physiol
2016[Jul]; 311
(1
): R1-9
PMID27097659
show ga
Preeclampsia (PE) is a pregnancy-associated disorder that affects 5-8% of
pregnancies and is a major cause of maternal, fetal, and neonatal morbidity and
mortality. Hallmark characteristics of PE are new onset hypertension after 20 wk
gestation with or without proteinuria, chronic immune activation, fetal growth
restriction, and maternal endothelial dysfunction. However, the
pathophysiological mechanisms that lead to the development of PE are poorly
understood. Recent data from studies of both clinical and animal models
demonstrate an imbalance in the subpopulations of CD4+ T cells and a role for
these cells as mediators of inflammation and hypertension during pregnancy.
Specifically, it has been proposed that the imbalance between two CD4+ T cell
subtypes, regulatory T cells (Tregs) and T-helper 17 cells (Th17s), is involved
in the pathophysiology of PE. Studies from our laboratory highlighting how this
imbalance contributes to vasoactive factors, endothelial dysfunction, and
hypertension during pregnancy will be discussed in this review. Therefore, the
purpose of this review is to highlight hypertensive mechanisms stimulated by
inflammatory factors in response to placental ischemia, thereby elucidating a
role.