Podocytes – potential biomarker for early diagnosis of pre-eclampsia

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Pre-eclampsia is a medical complication in pregnancy that occurs in about 5% of pregnant women, after the 20th week of gestation. This complication causes serious health effects on pregnant women, even death in both those women and their fetuses. Pre-eclampsia patients are characterized by gestational hypertension associated with proteinuria and histological evidence of glomerular injury. Many reports suggested certain biomarkers of pre-eclampsia, including a decreased VEGF (Vascular Epithelial Growth Factor) level or an increased sFlt-1 (VEGF receptor) level in serum, which is related to an increase in the risk of this issue. Pre-eclampsia might be associated with an increased risk of several kidney diseases for many years following diagnosis with this issue. Evidence showed that women with a history of pre-eclampsia might have a higher risk of kidney diseases such as end-stage renal disease (ESRD) and focal segmental glomerulosclerosis (FSGS) than women with healthy pregnancies. Other studies showed that podocytes might be involved in glomerular lesions in pre-eclampsia patients. Podocytes are specialized epithelial cells located on the surface of the glomerular capillary, which is part of the glomerular filter membrane along with the endothelial cells and the glomerular basement membrane. Podocytes have a responsibility to ensure the glomerular membrane’s selective permeability. Some methods recently are being developed to detect the podocytes in urine samples such as immunohistochemistry, Reverse Transcriptase Polymerase Chain Reaction (RT – PCR), suggesting the potential application of those cells as biomarkers in the early diagnosis of pre-eclampsia. This review summarized the evidence about the role of podocytes in the pathological mechanism of pre-eclampsia, the risk of chronic kidney diseases as well as the potential predictive value of podocytes in the early diagnosis of pre-eclampsia.