Molecular Targets of Aspirin and Prevention of Preeclampsia and Their Potential Association with Circulating Extracellular Vesicles during Pregnancy

• Published in: International journal of molecular sciences Vol. 20; no. 18; p. 4370
• Main Authors: Dutta, Suchismita, Kumar, Sathish, Hyett, Jon, Salomon, Carlos
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 05-09-2019; MDPI
• Subjects: Angiogenesis; Animals; Antiangiogenics; Aspirin; Aspirin - administration & dosage; Aspirin - adverse effects; Aspirin - therapeutic use; Biomarkers; Blood platelets; Coagulants; Coagulation factors; Diabetes mellitus; exosomes; Exosomes - metabolism; Extracellular vesicles; Extracellular Vesicles - metabolism; Female; Fetuses; Fibrinogen; Fibrinolysis; Gestation; Health risk assessment; Humans; Hypertension; Inflammation; low dose aspirin; Molecular Targeted Therapy; Mortality; Mothers; Oxidative stress; Physiology; Placenta; Placenta - drug effects; Placenta - metabolism; placentation; Plasminogen activator inhibitors; Pre-eclampsia; Pre-Eclampsia - etiology; Pre-Eclampsia - metabolism; Pre-Eclampsia - prevention & control; Preeclampsia; Pregnancy; Premature birth; Reproductive technologies; Review; Risk analysis; Risk factors; Smooth muscle; Treatment Outcome; Veins & arteries; Vesicles; Viscosity; Von Willebrand factor; Womens health; low dose aspirin; placentation; preeclampsia; exosomes; pregnancy
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms20184370

Uncomplicated healthy pregnancy is the outcome of successful fertilization, implantation of embryos, trophoblast development and adequate placentation. Any deviation in these cascades of events may lead to complicated pregnancies such as preeclampsia (PE). The current incidence of PE is 2-8% in all pregnancies worldwide, leading to high maternal as well as perinatal mortality and morbidity rates. A number of randomized controlled clinical trials observed the association between low dose aspirin (LDA) treatment in early gestational age and significant reduction of early onset of PE in high-risk pregnant women. However, a substantial knowledge gap exists in identifying the particular mechanism of action of aspirin on placental function. It is already established that the placental-derived exosomes (PdE) are present in the maternal circulation from 6 weeks of gestation, and exosomes contain bioactive molecules such as proteins, lipids and RNA that are a "fingerprint" of their originating cells. Interestingly, levels of exosomes are higher in PE compared to normal pregnancies, and changes in the level of PdE during the first trimester may be used to classify women at risk for developing PE. The aim of this review is to discuss the mechanisms of action of LDA on placental and maternal physiological systems including the role of PdE in these phenomena. This review article will contribute to the in-depth understanding of LDA-induced PE prevention.