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This review provides an alternative to the \u2018two\u2010stage model\u2019 of pre\u2010eclampsia in which abnormal spiral arteries modification leads to placental hypoxia, oxidative stress and aberrant maternal systemic inflammation. Very high maternal soluble fms\u2010like tyrosine kinase\u20101 (s<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>lt\u20101 also known as s<jats:styled-content style=\"fixed-case\">VEGFR<\/jats:styled-content>) and very low placenta growth factor (<jats:styled-content style=\"fixed-case\">PlGF<\/jats:styled-content>) are unique to pre\u2010eclampsia; however, abnormal spiral arteries and excessive inflammation are also prevalent in other placental disorders. Metaphorically speaking, pregnancy can be viewed as a car with an accelerator and brakes, where inflammation, oxidative stress and an imbalance in the angiogenic milieu act as the \u2018accelerator\u2019. The \u2018braking system\u2019 includes the protective pathways of haem oxygenase 1 (also referred as <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>mox1 or <jats:styled-content style=\"fixed-case\">HO<\/jats:styled-content>\u20101) and cystathionine\u2010<jats:styled-content style=\"fixed-case\">\u03b3<\/jats:styled-content>\u2010lyase (also known as <jats:styled-content style=\"fixed-case\">CSE<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>th), which generate carbon monoxide (<jats:styled-content style=\"fixed-case\"><jats:roman>CO<\/jats:roman><\/jats:styled-content>) and hydrogen sulphide (<jats:styled-content style=\"fixed-case\"><jats:roman>H<jats:sub>2<\/jats:sub>S<\/jats:roman><\/jats:styled-content>) respectively. The failure in these pathways (brakes) results in the pregnancy going out of control and the system crashing. Put simply, pre\u2010eclampsia is an accelerator\u2013brake defect disorder. <jats:styled-content style=\"fixed-case\"><jats:roman>CO<\/jats:roman><\/jats:styled-content> and <jats:styled-content style=\"fixed-case\"><jats:roman>H<jats:sub>2<\/jats:sub>S<\/jats:roman><\/jats:styled-content> hold great promise because of their unique ability to suppress the anti\u2010angiogenic factors s<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>lt\u20101 and soluble endoglin as well as to promote <jats:styled-content style=\"fixed-case\">PlGF<\/jats:styled-content> and endothelial <jats:styled-content style=\"fixed-case\">NOS<\/jats:styled-content> activity. The key to finding a cure lies in the identification of cheap, safe and effective drugs that induce the braking system to keep the pregnancy vehicle on track past the finishing line.<\/jats:p><\/jats:sec><jats:sec><jats:title>Linked Articles<\/jats:title><jats:p>This article is part of a themed section on Pharmacology of the Gasotransmitters. To view the other articles in this section visit <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/dx.doi.org\/10.1111\/bph.2015.172.issue-6\">http:\/\/dx.doi.org\/10.1111\/bph.2015.172.issue\u20106<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1111\/bph.12977","type":"journal-article","created":{"date-parts":[[2014,10,10]],"date-time":"2014-10-10T09:25:19Z","timestamp":1412933119000},"page":"1574-1586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Unravelling the theories of pre\u2010eclampsia: are the protective pathways the new paradigm?"],"prefix":"10.1111","volume":"172","author":[{"given":"Asif","family":"Ahmed","sequence":"first","affiliation":[{"name":"Vascular Therapeutics Unit Aston Medical School Aston University  Birmingham 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