Potential targets for the treatment of preeclampsia

Abstract

Introduction: Preeclampsia is a disorder of pregnancy, typically characterized by hypertension and proteinuria observed after the 20th week of gestation. Preeclampsia has dire consequences for both maternal and neonatal health: it is associated with 50,000 – 100,000 annual deaths globally, as well as serious fetal and neonatal morbidity and mortality, including increased risk of fetal growth restriction and still birth. Despite the severe health, social, and economic costs of preeclampsia, currently the only curative therapy is delivery of the baby and placenta, which itself carries the associated risks of premature birth. The lack of treatments for this condition is attributable to a number of causes, including but not limited to: a partial understanding of the complex pathophysiological mechanisms underlying this complex disease; an inability to sensitively predict women who will go on to develop the disease; and a paucity of robust animal models with which to test new treatments.

Areas covered: Recently, progress has been made in identifying potential new therapeutic targets. This review will discuss in detail the evidence supporting further investigation of these targets, which include angiogenic factors, agents that increase vasodilation, anti-inflammatory drugs, substances that reduce oxidative stress, and statins.

Expert opinion: New therapeutic targets have the potential to make a significant positive impact on maternal and neonatal health. It is exciting that a number of potential therapies are currently being investigated; however, it is also vital that basic research continues to identify potential mechanisms and targets, and that any potential therapy is thoroughly tested before progression to clinical trial.

Keywords:

• angiogenic factors
• anti-inflammatory; melatonin
• nitric oxide
• oxidative stress
• preeclampsia
• sildenafil
• statins
• VEGF

Declaration of interest

C Oyston has received grant funding from the GRAVIDA National Centre for Growth and Development, New Zealand (NZ), for studies on the use of sildenafil in pregnancy. P Baker has received grant funding from GRAVIDA, NZ, from the Medical Research Council (MRC), United Kingdom (UK), and from the Health Research Council, NZ, for studies on potential therapeutic targets in pre-eclampsia including the use of sildenafil. J Stanley from GRAVIDA, NZ and the MRC, UK. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

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