Abstract
[Figure: see text].
Highlights
Various studies found an association of different renin-angiotensin system (RAS) components with gestational duration and preterm birth, as well as with preeclampsia
Lower placental leucinyl aminopeptidase (LNPEP) in PE and in early gestation higher-risk patients implicates a new alternative RAS mechanism contributing to hypertension in pregnancy
We further investigated the expression of Ang-converting enzymes REN, ACE, ACE2, ENPEP, Aminopeptidase N (ANPEP), RNPEP, DPP3 (Figure S1, modified from19), which were partially present in the placenta to convert exogenous Ang depending on cell type (Figure 1A)
Summary
Various studies found an association of different renin-angiotensin system (RAS) components with gestational duration and preterm birth, as well as with preeclampsia. Lower placental LNPEP in preeclampsia and in first-trimester patients at high-risk for preeclampsia suggests a new alternative route in maternal RAS signaling and may contribute to hypertension and disease in pregnancy. 25% of firsttime pregnant women develop a mild to severe hypertension in pregnancy or even preeclampsia[1] and 37% develop elevated blood pressure but not overt hypertension.[2] Women diagnosed with gestational hypertension experience increased morbidity, including augmented rates of caesarean deliveries, abruptio placentae, and acute renal dysfunction.[1] Depending on the country of origin, 10% to 50% of women initially diagnosed with gestational hypertension end up developing preeclampsia in as short a period as 1 to 5 weeks.[3,4] chronic hypertension ranks second in risk factors for women developing preeclampsia (16%).[5]. Leptin downregulates placental LNPEP. Preeclamptic placentae and placentae from an early gestation high-risk population have decreased LNPEP compared with controls
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