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The primum movens of the disease is the defect of invasion of the uterine arteries by foetal syncytiotrophoblasts, which causes a maladaptive placental response to chronic hypoxia and the secretion of the soluble form of type 1 vascular growth endothelial factor receptor, also called soluble fms-like tyrosine kinase 1 (sFlt-1), the major player in the pathophysiology of the disease. Among its different effects, sFlt-1 induces abnormal sensitivity of the maternal vessels to the vasoconstrictor angiotensin II. This leads to the hypertensive phenotype, recently shown to be abrogated by the administration of sildenafil citrate, which can potentiate the vasodilatory mediator nitrite oxide. This review focuses on the mechanisms of maternal endothelial dysfunction in preeclampsia and discusses the therapeutic window of sildenafil use in the context of preeclampsia, based on the results from preclinical studies and clinical trials. Safety issues recently reported in neonates have considerably narrowed this window.<\/jats:p>","DOI":"10.1093\/ndt\/gfy328","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T03:22:37Z","timestamp":1539055357000},"page":"1819-1826","source":"Crossref","is-referenced-by-count":22,"title":["Sildenafil for the treatment of preeclampsia, an update: should we still be enthusiastic?"],"prefix":"10.1093","volume":"34","author":[{"given":"No\u00e9mie","family":"Simon-Tillaux","sequence":"first","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, H\u00f4pital Tenon, Assistance publique - H\u00f4pitaux de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edouard","family":"Lecarpentier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and Reproductive Medicine, University Paris Est Cr\u00e9teil, Centre Hospitalier Inter-Communal de Cr\u00e9teil, Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassilis","family":"Tsatsaris","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Port-Royal Maternity, Assistance publique - H\u00f4pitaux de Paris, Cochin Hospital, Paris, France"},{"name":"Paris Descartes University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Hertig","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, H\u00f4pital Tenon, Assistance publique - H\u00f4pitaux de Paris, Paris, France"},{"name":"Sorbonne Universit\u00e9, UPMC Universit\u00e9 Paris 06, UMR_S 1155, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,11,6]]},"reference":[{"key":"2019110402560699400_gfy328-B1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.preghy.2012.11.001","article-title":"The definition of severe and early-onset preeclampsia. 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