The etiology of preeclampsia.
The etiology of preeclampsia.
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DOI：
10.1016/j.ajog.2021.11.1356
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发表时间：
2022-03
影响因子：
9.8
通讯作者：
Erez O
中科院分区：
文献类型：
--
作者：
Jung E;Romero R;Yeo L;Gomez-Lopez N;Chaemsaithong P;Jaovisidha A;Gotsch F;Erez O
医学的一项基本任务是了解疾病的原因。先兆子痫和子痫是一种神秘而难以捉摸的疾病，被称为“理论疾病”。先兆子痫是一种“重大产科综合征”，其中多种且有时重叠的病理过程激活由内皮细胞活化、血管内炎症和合体滋养层应激组成的共同途径。本文讨论了潜在的病因，或因果关系的解释，先兆子痫。基于大量的临床和实验证据，子宫胎盘缺血的作用已得到充分证实。通过认识到牙周病和母体肠道菌群失调与动脉粥样硬化相关，从而可能与先兆子痫患者亚群相关，微生物的因果作用已得到认可。最近的报告表明，SARS-CoV-2感染似乎是因果关系的先兆子痫的审查，以及这种病毒感染可能导致这种综合征的机制。特定的病因因素，如母胎免疫耐受性的破坏，被认为是导致无父无母和卵子捐赠的先兆子痫的原因，可能部分通过子宫胎盘缺血起作用，而另一个因素，如胎盘老化，可能主要通过合体滋养层应激起作用。本文还探讨了妊娠期糖尿病与先兆子痫孕妇肥胖之间的关系。自身免疫，胎儿疾病和内分泌疾病的各种作用也进行了讨论。更深入地了解先兆子痫的病因对改善治疗和预防至关重要。这篇文章描述了先兆子痫的危险因素或病因。
A fundamental task in medicine is the understanding of the causes of diseases. Preeclampsia and eclampsia, an enigmatic and elusive disorder, have been labeled the “disease of theories.” Preeclampsia is one of the “great obstetrical syndromes” in which multiple and sometimes overlapping pathologic processes activate a common pathway composed of endothelial cell activation, intravascular inflammation, and syncytiotrophoblast stress. This article addresses the potential etiologies, or causal explanations, for preeclampsia. The role of uteroplacental ischemia is well established, based upon a solid body of clinical and experimental evidence. A causal role for microorganisms has gained recognition through the realization that periodontal disease and maternal gut dysbiosis are linked to atherosclerosis, thus possibly to a subset of patients with preeclampsia. The recent reports indicating that SARS-CoV-2 infection appears to be causally linked to preeclampsia are reviewed as well as the mechanisms whereby this viral infection can cause this syndrome. Particular etiological factors, such as the breakdown of maternal-fetal immune tolerance, thought to account for the excess of preeclampsia in primipaternity and egg donation—may operate, in part, through uteroplacental ischemia, while another, such as placental aging, may operate largely through syncytiotrophoblast stress. This article also examines the nature of the association between gestational diabetes mellitus and maternal obesity in preeclampsia. The various roles of autoimmunity, fetal diseases, and endocrine disorders are also discussed. A greater understanding of the etiologic factors of preeclampsia is essential to improve treatment and prevention. This article describes the causal risk factors, or etiology, of preeclampsia.
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影响因子：
8.3
作者：
Alexander, BT;Kassab, SE;Granger, JP
通讯作者：
Granger, JP
影响因子：
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作者：
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影响因子：
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DOI：
10.3109/14767058.2015.1032239
发表时间：
2016-04-02
影响因子：
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作者：
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通讯作者：
Prusac, Ivana Kuzmic
DOI：
10.1016/j.preghy.2021.01.002
发表时间：
2021-01-30
影响因子：
2.2
作者：
Altemani, Faisal;Barrett, Helen L.;Nitert, Marloes Dekker
通讯作者：
Nitert, Marloes Dekker