The placental problem: linking abnormal cytotrophoblast differentiation to the maternal symptoms of preeclampsia.
The placental problem: linking abnormal cytotrophoblast differentiation to the maternal symptoms of preeclampsia.
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DOI：
10.1186/1477-7827-2-53
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发表时间：
2004-07-05
期刊：
影响因子：
--
通讯作者：
Fisher, Susan J
中科院分区：
文献类型：
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作者：
Fisher, Susan J
胎盘是一个了不起的器官。在正常妊娠中，其特化细胞(称为细胞滋养层细胞)分化为各种特化亚群，在控制胎儿生长发育中发挥关键作用。一个细胞滋养细胞亚群获得肿瘤样特性，允许细胞侵入蜕膜和子宫肌层，这是一个将胎盘附着到子宫的过程。同一亚组还采用了一种血管表型，允许这些胎儿细胞打破并随后连接子宫血管，这一过程将母亲的血液输送到胎盘的其余部分。以突发性高血压、蛋白尿、水肿为特征的妊娠期并发症先兆子痫，细胞滋养层侵袭浅，血管转化不全。这些发现，加上最近来自动物模型的证据，表明先兆子痫与胎盘产生的血管生成/血管生成物质的异常产生有关，这些物质到达母体循环，有可能产生这种综合征的至少一个临床症状。目前的挑战是在这一知识的基础上设计临床上有用的测试，以预测、诊断和治疗这种危险的疾病。
The placenta is a remarkable organ. In normal pregnancy its specialized cells (termed cytotrophoblasts) differentiate into various specialized subpopulations that play pivotal roles in governing fetal growth and development. One cytotrophoblast subset acquires tumor-like properties that allow the cells to invade the decidua and myometrium, a process that attaches the placenta to the uterus. The same subset also adopts a vascular phenotype that allows these fetal cells to breach and subsequently line uterine blood vessels, a process that channels maternal blood to the rest of the placenta. In the pregnancy complication preeclampsia, which is characterized by the sudden onset of maternal hypertension, proteinuria and edema, cytotrophoblast invasion is shallow and vascular transformation incomplete. These findings, together with very recent evidence from animal models, suggest that preeclampsia is associated with abnormal placental production of vasculogenic/angiogenic substances that reach the maternal circulation with the potential to produce at least a subset of the clinical signs of this syndrome. The current challenge is to build on this knowledge to design clinically useful tests for predicting, diagnosing and treating this dangerous disorder.