Pre‐eclampsia is a hypertensive disease of pregnancy characterized by new‐onset hypertension, with either proteinuria and/or organ dysfunction. Pre‐eclampsia is a leading cause of maternal morbidity and mortality; however, the underlying cellular and molecular mechanisms are not well understood. There is consensus that the underlying mechanism(s) resulting in pre‐eclampsia is centered around abnormal placentation, inadequate spiral‐artery remodeling, and deficiency in trophoblast invasion, resulting in impaired maternal blood flow to the placenta and a release of signals and/or inflammatory mediators into maternal circulation triggering the systemic manifestations of pre‐eclampsia. ER stress, resulting in impaired autophagy and placental release of aggregated proteins, may also confer systemic stress to maternal organs in pre‐eclampsia. Extracellular vesicles (EVs), lipid‐bilayer enclosed structures containing macromolecules including proteins, miRNA, and other important nucleotides, have been suggested to play an important role in this maternal‐fetal communication. Circulating EVs are present in greater quantity in the plasma of pre‐eclampsia subjects compared to normal pregnancy, and the placental derived EVs have been shown to have altered protein and RNA cargo. In this review, we will focus on EVs and their role in pre‐eclampsia, specifically their role in immune responses, inflammation, altered angiogenesis, and endothelial dysfunction.

中文翻译：

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胎盘细胞外囊泡和先兆子痫

先兆子痫是一种以新发高血压为特征的妊娠期高血压疾病，伴有蛋白尿和/或器官功能障碍。先兆子痫是孕产妇发病率和死亡率的主要原因；然而，潜在的细胞和分子机制尚不清楚。有共识认为，导致先兆子痫的潜在机制集中在胎盘异常、螺旋动脉重塑不足和滋养层侵袭不足，导致母体流向胎盘的血流受损以及信号和/或信号的释放。炎症介质进入母体循环，引发先兆子痫的全身表现。内质网应激导致自噬和胎盘释放聚集蛋白受损，也可能给先兆子痫的母体器官带来全身性应激。细胞外囊泡 (EVs) 是一种包含大分子（包括蛋白质、miRNA 和其他重要核苷酸）的脂质双层封闭结构，已被认为在母胎通讯中发挥重要作用。与正常妊娠相比，先兆子痫受试者血浆中的循环 EV 数量更多，并且胎盘衍生的 EV 已被证明具有改变的蛋白质和 RNA 货物。在这篇综述中，我们将重点关注 EV 及其在先兆子痫中的作用，特别是它们在免疫反应、炎症、血管生成改变和内皮功能障碍中的作用。与正常妊娠相比，先兆子痫受试者血浆中的循环 EV 数量更多，并且胎盘衍生的 EV 已被证明具有改变的蛋白质和 RNA 货物。在这篇综述中，我们将重点关注 EV 及其在先兆子痫中的作用，特别是它们在免疫反应、炎症、血管生成改变和内皮功能障碍中的作用。与正常妊娠相比，先兆子痫受试者血浆中的循环 EV 数量更多，并且胎盘衍生的 EV 已被证明具有改变的蛋白质和 RNA 货物。在这篇综述中，我们将重点关注 EV 及其在先兆子痫中的作用，特别是它们在免疫反应、炎症、血管生成改变和内皮功能障碍中的作用。