胎盘外泌体在子痫前期的研究进展

The Role of Placental Exosomes in Preeclampsia

子痫前期(preeclampsia,PE)作为妊娠并发症中最为严重的一种,目前还没有有效的治疗方法。外泌体与受体细胞相互作用并将蛋白质、脂质和RNA传递给这些细胞,胎盘外泌体作为妊娠时特异性的外泌体,在维持正常妊娠过程中发挥重要作用,其在病理妊娠中的机制也值得探究。回顾近年PE相关的文献,从胎盘外泌体在正常妊娠的作用出发总结了其在PE的发病机制中可能的作用,从胎盘外泌体数量和装载物质的变化到其在母体免疫耐受中发挥的作用,论证了胎盘外泌体可以从多个信号传导通路免疫介导的机制促成PE的发病机制,总结了近年发现的血源性生物标记物,也提出微小RNA作为PE的生物标记物的可能性,讨论胎盘外泌体在PE的早发现早治疗中的作用,以期为PE未来的研究和治疗提供一些借鉴。

Preeclampsia(PE) is one of the most serious complications of pregnancy, and there is no effective treatment at present. Exosomes interact with recipient cells and pass proteins, lipids and RNA to these recipient cells. Placental exosomes, as a kind of specific exosomes during pregnancy, play an important role in maintaining normal pregnancy. It is necessary to study the effect of placental exosomes and mechanism in pathological pregnancy. In this article, we review the recent PE-related literatures and summarize the possible roles of placental exosomes in normal pregnancy and the pathogenesis of PE, including the quantity and content feature of placental exosomes, the maternal immune tolerance and related pathways. It is demonstrated that placental exosomes can contribute to the pathogenesis of PE by multiple signaling pathways and immune-mediated mechanisms. The blood-borne biomarkers and microRNAs from placental exosomes could be developed as the biomarkers of PE. We discuss the possible roles of placental exosomes in the early detection and treatment of PE,in order to provide some reference for future research and treatment of PE.