{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:13:15Z","timestamp":1787015595250,"version":"build-2736575974"},"reference-count":74,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      Preeclampsia (\n                      <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\n                      ) is a severe pregnancy\u2010related disorder characterized by hypertension and multi\u2010organ failure, primarily affecting the maternal vasculature and placenta. The aim of this review is to explain the molecular mechanisms behind\n                      <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\n                      by investigating the relationship between exosome release and complement activation, which could provide insight into potential therapeutic targets.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review analyzes existing literature on the role of the complement system and exosomes in the pathophysiology of PE. The focus is on how abnormal complement activation contributes to inflammation and vascular dysfunction, particularly in the placenta, and the role of trophoblast\u2010derived exosomes carrying pathogenic molecules such as soluble fms\u2010like tyrosine kinase\u20101 (sFlt\u20101) and soluble endoglin (sEng).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings from recent studies indicate that during PE, abnormal complement activation leads to severe inflammation and vascular dysfunction in the placenta. Additionally, exosomes, particularly those derived from trophoblasts, are present in higher concentrations in maternal circulation during PE and carry molecules that disrupt endothelial function. These factors contribute to the development of hypertension and other maternal complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Understanding the interaction between complement activation and exosome release in PE may open avenues for novel therapeutic approaches. Targeting complement regulation and exosome\u2010mediated signaling could potentially improve maternal and fetal outcomes, offering new strategies for managing this complex condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.16255","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T04:59:58Z","timestamp":1741755598000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Exosomal\u2010complement system activation in preeclampsia"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0688-157X","authenticated-orcid":false,"given":"M.","family":"David","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences University of the Free State  Bloemfontein South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9210-9913","authenticated-orcid":false,"given":"N.","family":"Maharaj","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences University of the Free State  Bloemfontein South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8886-8482","authenticated-orcid":false,"given":"A.","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Precision Medicine and Integrated Nano\u2010Diagnostics (P\u2010MIND) Research Group, Office of the Dean, Faculty of Health Sciences University of the Free State  Bloemfontein South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2021.09.008"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.10803"},{"key":"e_1_2_10_4_1","first-page":"109","article-title":"Hypertensive disorders in pregnancy: 2019 national guideline","volume":"109","author":"Moodley J","year":"2019","journal-title":"S Afr Med J"},{"key":"e_1_2_10_5_1","first-page":"1","article-title":"Dysregulation of complement activation and placental dysfunction: a potential target to treat preeclampsia?","volume":"10","author":"Pierik E","year":"2019","journal-title":"Front Immunol"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.01681"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2019.01.009"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/aji.12788"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/20013078.2020.1722385"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells10071812"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.0525-17.2017"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.02630"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2013.08.001"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2015.01460"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-017-0784-4"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.10.003"},{"key":"e_1_2_10_17_1","volume-title":"Complement as a regulator of adaptive immunity. 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