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Review
. 2023 Oct 1;158(4):385-396.
doi: 10.4103/ijmr.ijmr_2143_22. Epub 2023 Sep 25.

Early prediction of pre-eclampsia using circulating placental exosomes: Newer insights

Aishwarya Rao  1 , Uma Shinde  2 , Dhanjit Kumar Das  3 , Nafisa Balasinor  2 , Taruna Madan  1
Affiliations
Review

Early prediction of pre-eclampsia using circulating placental exosomes: Newer insights

Aishwarya Rao et al. Indian J Med Res. .

Abstract

Pre-eclampsia (PE), a multifactorial de novo hypertensive pregnancy disorder, is one of the leading causes of foeto-maternal morbidity and mortality. Currently, antihypertensive drugs are the first-line therapy for PE and evidence suggests that low-dose aspirin initiated early in high risk pregnancies may reduce the risk of development or severity of PE. However, an early prediction of this disorder remains an unmet clinical challenge. Several potential serum biomarkers associated with maternal immunoregulation and placental angiogenesis have been evaluated but are ineffective and inconsistent for early prediction. Although placental biomarkers would be more specific and sensitive in predicting the risk of PE, accessing the placenta during pregnancy is not feasible. Circulating placental exosomes (pEXO), originating from foeto-maternal interface, are being evaluated as the placenta's surrogate and the best source of non-invasive placental biomarkers. pEXO appear in the maternal circulation starting from six weeks of gestation and its dynamic biological cargo across pregnancy is associated with successful pregnancy outcomes. Therefore, monitoring changes in pEXO expression profiles could provide new insights into the prediction, diagnosis and treatment of PE. This narrative review comprehensively summarizes the available literature on the candidate predictive circulating biomarkers evaluated for PE to date. In particular, the review elucidates the current knowledge of distinct molecular signatures emanating from pEXO in pre-eclamptic women to support the discovery of novel early predictive biomarkers for effective intervention and management of the disease.

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Conflict of interest statement

None.

Figures

Figure
Figure
A schematic illustration of the cargo typically carried by placental exosomes. The molecular cargo of a placental exosome mainly consists of tetraspanins - CD63, CD9, PLAP, cytoskeletal proteins, syncytin-1/2, apoptotic proteins Fas ligand, TNF-related apoptosis-inducing ligand, ULBP-1, ESCRTs, nucleic acids (DNA, mRNA, shRNA, lncRNA and miRNAs) of the originating trophoblasts,-(Part of the figure created with BioRender.com).
See this image and copyright information in PMC

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References

    1. Demand N. Ancient society and history. Baltimore: Johns Hopkins University Press; 1994. Birth, Death, and Motherhood in Classical Greece.
    1. Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170((1)):1–7. - PubMed
    1. Magee LA, Sharma S, Nathan HL, Adetoro OO, Bellad MB, Goudar S, et al. The incidence of pregnancy hypertension in India, Pakistan, Mozambique, and Nigeria: A prospective population-level analysis. PLoS Med. 2019;16((4)):e1002783. - PMC - PubMed
    1. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135((6)):1492–95. - PubMed
    1. Ray JG, Bartsch E, Medcalf KE, Park AL, Ray JG. Clinical risk factors for pre-eclampsia determined in early pregnancy:systematic review and meta-analysis of large cohort studies on behalf of the High Risk of Pre-eclampsia Identification Group. BMJ. 2016;353:i1753. - PMC - PubMed