Regulation of the Placental Renin-Angiotensin-Aldosterone System in Early- and Late-Onset Preeclampsia

Abstract

Preeclampsia (PE) is one of the most dangerous complications of pregnancy, characterized by hypertension, proteinuria, and symptoms of multiple organ failure, which are detected de novo after 20 weeks of pregnancy. The renin–angiotensin–aldosterone system (RAAS) is one of the first to recognize pregnancy and is an important regulator of blood pressure. The placenta has its own RAAS, the role of which in the development of PE is not fully understood. In this work, for the first time, we characterized the expression of RAAS components and miRNAs controlling it in the placenta at various times of PE manifestation. The data obtained will allow the development of a new strategy in the future for the search for therapeutic agents for patients suffering from PE and cardiovascular diseases.

Approach to the Patient: Reninoma

“…A local placental RAAS is formed separately from maternal circulation from 6 weeks’ gestation and is most active in early pregnancy ( 41 ). A key product of the RAAS, angiotensin II, acts as an important growth factor, promoting invasion of trophoblast cells, cell proliferation, and migration and angiogenesis ( 43 ). Angiotensin II is also an important trophic factor for vascular smooth muscle, the adrenal cortex, and cardiac myositis.…”