Abstract
Placental vascularization is a tightly regulated physiological process in which the maternal immune system plays a fundamental role. Vascularization of the maternal-placental interface involves a wide range of mechanisms primarily orchestrated by the fetal extravillous trophoblast and maternal immune cells. In a healthy pregnancy, an immune cross-talk between the mother and fetal cells results in the secretion of immunomodulatory mediators, apoptosis of specific cells, cellular differentiation/proliferation, angiogenesis, and vasculogenesis, altogether favoring a suitable microenvironment for the developing embryo. In the context of vasculopathy underlying common pregnancy disorders, it is believed that inefficient invasion of extravillous trophoblast cells in the endometrium leads to a poor placental blood supply, which, in turn, leads to decreased secretion of angiogenic factors, hypoxia, and inflammation commonly associated with preterm delivery, intrauterine growth restriction, and preeclampsia. In this review, we will focus on studies published by Latin American research groups, providing an extensive review of the role of genetic variants from candidate genes involved in a broad spectrum of biological processes underlying the pathophysiology of preeclampsia. In addition, we will discuss how these studies contribute to fill gaps in the current understanding of preeclampsia. Finally, we discuss some trending topics from important fields associated with pregnancy vascular disorders (e.g., epigenetics, transplantation biology, and non-coding RNAs) and underscore their possible implications in the pathophysiology of preeclampsia. As a result, these efforts are expected to give an overview of the extent of scientific research produced in Latin America and encourage multicentric collaborations by highlighted regional research groups involved in preeclampsia investigation.
Highlights
In all pregnancies that can potentially lead to living birth, a major concern is the high prevalence of disorders that can affect healthy pregnancies
In another study evaluating methylenetetrahydrofolate reductase (MTHFR) (C677T) in MayaMestizo PE women, it was observed that MTHFR “T” allele and the “TT” genotype were more frequent in controls, suggesting a decreased risk of PE in women carrying this variant (Canto et al, 2008)
The association of PE and single nucleotide polymorphisms (SNPs) of nitric oxide synthase 3, NOS3 (G894T, T-786C, and a variable number of tandem repeats (VNTR) with intron 4), MMP2 (C-1306T), and matrix metalloproteinase 9 (MMP9) (C-1562T) genes was investigated through a prospective case-control study in a southeastern Brazilian population
Summary
In all pregnancies that can potentially lead to living birth, a major concern is the high prevalence of disorders that can affect healthy pregnancies. In another study, Alpoim et al (2014) evaluated these same eNOS SNPs in early and late severe preeclamptic Brazilian women, and in a group of normotensive/healthy pregnant controls.
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