New aspects in the pathophysiology of preeclampsia

John M. Davison, Volker Homuth, Arun Jeyabalan, Kirk P. Conrad, S. Ananth Karumanchi, Susan Quaggin, Ralf Dechend, Friedrich C. Luft*

*Corresponding author for this work

Research output: Contribution to journalReview article

150 Scopus citations

Abstract

Preeclampsia, the de novo occurrence of hypertension and proteinuria after the 20th week of gestation, continues to exert an inordinate toll on mothers and children alike. Recent clinical trials, new physiologic insights, and novel observations on pathogenesis have altered the thinking about preeclampsia. The mechanisms surrounding relaxin and its effects on the circulation and on matrix metalloproteinases have been elucidated. The growth factor's receptor, fms-like tyrosine kinase 1, has been shown to exist in a soluble form that is able to inactivate vascular endothelial-derived growth factor and human placental growth factor. Compelling evidence has been brought forth suggesting that fms-like tyrosine kinase 1 is a circulating factor that can cause preeclampsia. Preeclamptic women have high circulating levels of asymmetric dimethyl arginine that could account for the generalized endothelial dysfunction observed in preeclampsia. Preeclamptic women also produce novel autoantibodies that may serve to activate angiotensin receptors. These new observations raise the possibility that the treatment of preeclamptic women will soon be improved.

Original languageEnglish (US)
Pages (from-to)2440-2448
Number of pages9
JournalJournal of the American Society of Nephrology
Volume15
Issue number9
DOIs
StatePublished - Sep 2004

ASJC Scopus subject areas

  • Nephrology

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    Davison, J. M., Homuth, V., Jeyabalan, A., Conrad, K. P., Karumanchi, S. A., Quaggin, S., Dechend, R., & Luft, F. C. (2004). New aspects in the pathophysiology of preeclampsia. Journal of the American Society of Nephrology, 15(9), 2440-2448. https://doi.org/10.1097/01.ASN.0000135975.90889.60