The placental pursuit for an adequate oxidant balance between the mother and the fetus.
The placental pursuit for an adequate oxidant balance between the mother and the fetus.
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DOI：
10.3389/fphar.2014.00149
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发表时间：
2014
影响因子：
5.6
通讯作者：
Llanos AJ
中科院分区：
文献类型：
--
作者：
Herrera EA;Krause B;Ebensperger G;Reyes RV;Casanello P;Parra-Cordero M;Llanos AJ
胎盘是调节母体与发育中的胎儿之间代谢过程的交换器官。该器官的正常功能对于生理妊娠过程以及最终产出健康的婴儿显然至关重要。脐胎盘血管系统有能力对母胎环境的变化做出反应。根据损伤的强度和程度，这些反应可能是即时的、中期的和长期的，导致日后潜在的形态结构和功能变化。这些调整通常会补偿最初的损伤，但偶尔可能转变为长期的重塑和功能失调过程，产生适应不良。现代围产医学中最具挑战性的情况之一是发育过程中的缺氧和氧化应激，这两种病症在高海拔地区以及低海拔胎盘功能不全时都会出现。缺氧和氧化应激可能导致内皮功能障碍，从而减少胎盘灌注，限制胎儿生长发育。本综述将重点关注胎盘对缺氧状况（通常与高海拔和胎盘功能不全有关）的反应，这些反应会导致氧化应激和血管疾病，影响胎儿和母体健康。尽管日常临床实践、基础和临床研究都清楚地提供了孕期缺氧和氧化应激形成的严重影响的证据，但在这些情况下，迫切需要进一步研究脐带和胎盘血管功能，以阐明仍未解决的众多问题。
The placenta is the exchange organ that regulates metabolic processes between the mother and her developing fetus. The adequate function of this organ is clearly vital for a physiologic gestational process and a healthy baby as final outcome. The umbilico-placental vasculature has the capacity to respond to variations in the materno-fetal milieu. Depending on the intensity and the extensity of the insult, these responses may be immediate-, mediate-, and long-lasting, deriving in potential morphostructural and functional changes later in life. These adjustments usually compensate the initial insults, but occasionally may switch to long-lasting remodeling and dysfunctional processes, arising maladaptation. One of the most challenging conditions in modern perinatology is hypoxia and oxidative stress during development, both disorders occurring in high-altitude and in low-altitude placental insufficiency. Hypoxia and oxidative stress may induce endothelial dysfunction and thus, reduction in the perfusion of the placenta and restriction in the fetal growth and development. This Review will focus on placental responses to hypoxic conditions, usually related with high-altitude and placental insufficiency, deriving in oxidative stress and vascular disorders, altering fetal and maternal health. Although day-to-day clinical practice, basic and clinical research are clearly providing evidence of the severe impact of oxygen deficiency and oxidative stress establishment during pregnancy, further research on umbilical and placental vascular function under these conditions is badly needed to clarify the myriad of questions still unsettled.
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