TITLE:
A Review: Molecular Concepts and Common Pathways Involving Vitamin D in the Pathophysiology of Preeclampsia
AUTHORS:
Kareem Washington, Somiranjan Ghosh, Inez V. Reeves
KEYWORDS:
Vitamin D Deficiency, Preeclampsia, Gestational Hypertension, Placentation
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.3,
March
15,
2018
ABSTRACT: Preeclampsia is one of the most serious conditions
at the end of pregnancy, causing increased perinatal morbidity and mortality to
the pregnant mother and her product of conception. It remains a high-risk
disease in ethnic minorities worldwide. Conception
involves fetal invasion and implantation, followed by an actively forming and
shedding decidua, an important uterine activity facilitating placental
development. Dysregulation in conception mediates functional changes that
induce onset of preeclampsia. The pathophysiology of preeclampsia primarily
results from impaired trophoblastic invasion and implantation with subsequent
vasculopathy. These events trigger exaggerated ischemic, inflammatory and immunologic
events in the placenta bed that disrupt implantation. As the underlying
mechanism(s) of preeclampsia remain obscure, there is increasing evidence that
Vitamin D deficiency during pregnancy potentiates hypertensive states that
could lead to the development of preeclampsia. As a prohormone, Vitamin D regulates
molecular events within central pathophysiological pathways of implantation and vascular development.
We review shared pathways involving Vitamin D modulation of pathologic events
in implantation associated with preeclampsia. Understanding the causal
mechanisms between Vitamin D and preeclampsia during early stages of conception
could allude to development of candidate markers for treatment or screening,
and decipher “hot spots” for research and intervention of, at-risk
pregnant mothers.