Is apoptosis cause of pre-eclampsia?

M. Buemi, A. Allegra, R. D’Anna*, C. Aloisi, F. Corica, M.V. Jasonni**, M. Senatore, N. Frisina

Cattedra di Nefrologia, Dipartimento di Medicina Interna, *Istituto di Ostetricia e Ginecologia – University of Messina (Italy)
**Clinica Ostetrica e Ginecologica – University of Modena (Italy)

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• Nephrology

Abstract. – Pre-eclampsia is the main cause of fetal and maternal morbidity and death associated with hypertension during complicating pregnancy. During physiological pregnancy, the immunological system undergoes secondary modifications, with an “exchange” between mother and fetus. Cytokines play an important role in the complex condition of partial fetal “rejection”. It has suggested that the condition depend on immunological factors. In line with this hypothesis, apoptosis appear to play a key role in the pathophysiology of placental ischemia and the mechanism underlying this condition may be influenced by substances such as Bcl-2 which inhibits apoptosis. Neither aspirin nor calcium appear to improve maternal hypertension and proteinuria, although late ongoing trials may alter this view. At present, the condition can be resolved only by the end of pregnancy. Further studies are required in order to improve our understanding of these immunological mechanisms underlying hypertension during pregnancy, as the key to effective therapy may be their ability to “manipulate” them in an appropriate way.

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