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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2025№2
Modern concept of the development...

Modern concept of the development of preeclampsia: new data

DOI
https://dx.doi.org/10.18565/aig.2024.272

Sidorova I.S., Managadze I.J.

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia

This article represents a unique modern concept of neuroimmune mechanisms in the genesis of preeclampsia that are mediated by neuron-specific proteins (NSP). This concept is confirmed by relevant data in world literature both on the nature and essence of preeclampsia, and new diagnostic and therapeutic strategies. For the first time, the domestic literature reveals the concept of neuroplacentation and fetal programming influenced by the placenta, and the hypothesis is put forward about their role in the pathogenesis of preeclampsia. The data on the role of NSP as biomarkers of neurocorticogenesis, fetal and maternal brain damage, as well as the functional status of the blood-brain barrier (BBB) and mechanisms of endothelial dysfunction, including the impact of damage-associated molecules and hyperactivation of the complement system in the development of PE is systematized. The latest information on the identified therapeutic targets in PE and possibilities of their modification and application in clinical practice is represented. Comparative analysis of a large number of clinical observations, the data on general and special research methods, as well as more than 20 years of our own research made it possible to develop, provide scientific explanation and advance a new concept of understanding preeclampsia, that is based on the key role of NSP, BBB and hyperactivation of the complement immune defense.
The aim of this paper is to identify the temporal and causal relationship between impairments of neuroplacentation, fetal neurocorticogenesis, NSP, increased permeability of the BBB in the development of preeclampsia, as well as search for new pathogenetic strategies for its prevention and treatment. 
Conclusion: This article will help specialists to understand the nature of preeclampsia as a multisystem neuroinflammatory gestational endotheliosis, leading not only to impairment of cerebral vascular function and integrity of the BBB, both in the mother and the fetus, but also to pathological programming of further child neurodevelopment and long-term neurodegenerative processes in mother. The proposed concept will help to revise therapeutic approaches to management of patients with preeclampsia, opens possibilities for application of innovative approaches to treatment and search for new therapeutic targets. 

Authors' contributions: Sidorova I.S. – the concept and design of the study, text editing; Sidorova I.S., Managadze I.J. – literature data collection and analysis, text writing. 
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
For citation:  Sidorova I.S., Managadze I.J. Modern concept of the development of preeclampsia: new data.
Akusherstvo i Gynekologia/Obstetrics and Gynecology. 2025; (2): 5-13 (in Russian)
https://dx.doi.org/10.18565/aig.2024.272

Keywords

preeclampsia
neuroplacentation
neurocorticogenesis
endothelial dysfunction
immune complexes
BBB
neuron-specific proteins in fetal brain
NSE
S100B
GFAP
NfL
tau
Full text (in Russian)

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Received 30.10.2024

Accepted 27.12.2024

About the Authors

Iraida S. Sidorova, Dr. Med. Sci., Professor, Academician of the RAS, Merited Scholar of the Russian Federation, Merited Doctor of the Russian Federation, Professor at the Department of Obstetrics and Gynecology №1, Medical Faculty, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University),
119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(499) 248-67-29, sidorovais@yandex.ru
Ioanna J. Managadze, student, N.V. Sklifosovsky ICM, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University),
119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(495)609-14-00, ktb1966@mail.ru

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