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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№1
Current understanding of preeclampsia with...

Current understanding of preeclampsia with regard to the role of fetal brain neuronspecific proteins

DOI
https://dx.doi.org/10.18565/aig.2024.221

Sidorova I.S., Managadze I.J.

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

This article presents current data from the world literature and more than 20 years of research conducted by the authors into the nature and essence of preeclampsia as a multisystem neuroinflammatory gestational endotheliosis leading to the impairment of the cerebrovascular function and blood-brain barrier (BBB) integrity in both mother and fetus. Neuron-specific proteins (NSPs) as biomarkers of higher structures of the fetal central nervous system, its neuro- and corticogenesis have been shown to play a leading role in determining changes in the fetal brain. Since preeclampsia is a condition observed only in humans, the study of cerebrovascular changes at the level of BBB and the detection of abnormalities of its integrity and permeability in women with preeclampsia represent a challenging task. It is limited not only by clinical trials, but also by the use of imaging techniques and biomarkers in experiment. Neurofilament light chain (NfL), tau protein, neuron-specific enolase (NSE) and S100B are of particular interest. It is necessary to understand how preeclampsia impairs cerebrovascular function and maternal-fetal BBB integrity, causing NSPs to enter the maternal circulation, triggering an immune response with the formation of circulating immune complexes and complement activation through an abnormal pathway, and initiating systemic endothelial dysfunction. The comparative analysis of a large number of clinical observations, as well as data from general and special research, resulted in the development of a new scientific concept for understanding preeclampsia. This concept is based on the key role of NSPs, BBB and hyperactivation of complementary immune defense. The aim of the article is to identify the causal relationship of impaired fetal neurocorticogenesis, NSPs, and increased BBB permeability in the development of preeclampsia.
Conclusion: The proposed concept suggests the revision of therapeutic approaches to the management of patients with preeclampsia, opens the possibility of using innovative approaches to treatment and searching for new therapeutic targets.

Authors' contributions: Sidorova I.S. – developing the concept and design of the study, editing the text; 
Sidorova I.S., Managadze I.J. – collection and analysis of the literary data, writing the text.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Sidorova I.S., Managadze I.J. Current understanding of preeclampsia with 
regard to the role of fetal brain neuron-specific proteins.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (1): 5-11 (in Russian)
https://dx.doi.org/10.18565/aig.2024.221

Keywords

preeclampsia
endotheliosis
immune complexes
BBB
fetal brain neuro-specific proteins
NSE
S100B
NfL
tau
Full text (in Russian)

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Received 03.09.2024

Accepted 25.12.2024

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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