The Role of Humoral Autoimmunity in the Pathophysiology of Preeclampsia.

IMPORTANCE

Preeclampsia (PE) remains a leading cause of maternal mortality worldwide. Research has shown multifactorial contributions to its pathophysiology. With recent evidence suggesting that humoral autoimmunity plays a crucial role, autoantibodies targeting vascular and immune pathways contribute to disease progression. Further research into the role of humoral autoimmunity in the etiology of PE and potential treatments could significantly improve maternal and fetal health.

OBJECTIVE

This study aims to provide an overview of current research on the role of autoantibodies in humoral autoimmunity and their contribution to the pathophysiology of PE.

EVIDENCE ACQUISITION: A comprehensive search was conducted in the PubMed database using the keywords "preeclampsia" and "autoantibody" to identify potentially pathogenic autoantibodies in preeclampsia. We performed follow-up searches with the keywords "preeclampsia" and identified autoantibodies such as "AT1-AA."

RESULTS

Autoantibodies, particularly angiotensin II type 1 receptor autoantibodies (AT1-AA) and endothelin-1 type A receptor autoantibodies (ETAR-AA), play a crucial role in PE by directly modulating vascular tone and promoting inflammation through mechanisms such as vasoconstriction and oxidative stress. Preeclampsia is also associated with other autoantibodies, including anti-beta-2-glycoprotein and lupus anticoagulant. Emerging research suggests that targeting these autoantibodies or their downstream receptors may be a promising therapeutic strategy for reducing disease severity.

CONCLUSIONS AND RELEVANCE: Humoral autoimmunity plays a significant role in the pathophysiology of PE, offering novel diagnostic and potential therapeutic avenues. Emerging treatments targeting these pathways show promise in alleviating PE symptoms. Further research into autoantibody mechanisms and targeted interventions is essential for improving outcomes in PE-affected pregnancies.