THE ROLE OF INTERACTIONS BETWEEN TROPHOBLASTDERIVED EXTRACELLULAR MICROVESICLES, IMMUNE CELLS AND ENDOTHELIUM IN PATHOGENESIS OF PRE-ECLAMPSIA

Abstract

Pre-eclampsia is a multisystemic disease that occurs in the second half of pregnancy, being characterized by the development of hypertension and proteinuria. Pre-eclampsia is still one of the main causes of maternal and neonatal morbidity and mortality. Pre-eclampsia is believed to be a result of complex interactions between maternal and placental factors. However, the exact pathophysiology of this syndrome remains unclear. Intercellular interactions are the basis of fetoplacental development in physiological pregnancy. A special mechanism of intercellular interactions is associated with the release of membranebound extracellular microvesicles by cells. Concentration and molecular composition of extracellular vesicles in biological fluids depend on the producer cell types, as well as the stimuli that trigger their formation. The studies of extracellular vesicles in pre-eclampsia focus on the particles produced by the cells of maternal cardiovascular system (endothelium, smooth muscle cells of blood vessels), and blood (erythrocytes, leukocytes, and platelets), like as by the cells of syncytiotrophoblast. Changed concentrations and molecular composition of these extracellular vesicles can contribute to the pathophysiology of pre-eclampsia, due to increased proinflammatory and procoagulant state occurring during pregnancy. This review focuses, firstly, on characteristics of the extracellular vesicles produced by syncytiotrophoblast, and possible role of their interaction with maternal immune cells, endothelial cells and platelets in the course of developing pre-eclampsia. Understanding the role of extracellular vesicles of syncytiotrophoblast in pathogenesis of pre-eclampsia could suggest an opportunity of providing these results for early and non-invasive diagnostics of placental disorders, as well as for predicting development of this disease.