The role of apoptosis in preeclampsia.

Altered apoptosis is involved in each step of the pathogenesis of preeclampsia. While deficient apoptosis may induce a maternal immune response against the fetus, enhanced apoptosis may interfere with the process of placentation, placental ischemia and subsequently, systemic endothelial damage. Thus, treatment modalities to inhibit or acclerate apoptosis cannot be employed in early pregnancy for prevention. Later in pregnancy, it would make sense to test treatment modalities that inhibit hypoxia-mediated apoptosis in patients in whom early testing, such as abnormal Doppler of the uterine artery, indicates the initiation of preeclampsia. This, however, has first to be tested in animal models. Since multiple different mechanisms, rather than a single factor, could contribute to the development of apoptosis, further studies to clarify the signaling mechanisms of apoptosis in preeclampsia should be conducted before any investigational treatment modalities are employed.