Gynecology, Obstetrics and Perinatology

The role of placental exosomes in the development of pregnancy complications

Exosomes (vesicles with the size of 30–150 nm) are formed in multivesicular bodies (MVB) by invagination of early endosome membranes and mediate intercellular interactions. Exosomes are secreted by various kinds of cells, their content might be represented by proteins, lipids and nucleic acids, which reflect the functional state of donor cells. The effect of exosomes on recipient cells depends on their quantity and characteristics of their «load». Comparatively recently, placental exosomes secreted by various placental cells have been isolated from blood of pregnant women. A specific protein – placental alkaline phosphatase (PLAP) – has been determined for these exosomes. PLAP-positive exosomes can be found in maternal blood as soon as in the first trimester of pregnancy, their number increases with maturation of the foetus and reaches its maximum by the moment of birth. Although the functional significance of placental exosomes is still investigated, some authors relate changes in the placental exosome profile (their number and composition) to placental dysfunction underlying the development of complications of pregnancy. Isolation of exosomes from blood of pregnant women (fluid biopsy) and determination of their biological characteristics might be regarded as early noninvasive diagnosis of structural and functional placental abnormalities. The appearing evidence of blastocyst-secreted exosomes and their role in modulating maternal immunity and endometrial receptiveness during implantation are also promising. The review presents data about the biogenesis, structure and functions of exosomes and the role of placenta-associated exosomes in the development of physiological and complicated pregnancy, and also about the possibility of using exosomes as a marker of the state of the blastocyst in assisted reproductive technologies, in particular, in oocyte donation and surrogate motherhood. 

Key words: pregnancy, assisted reproductive technologies, oocyte donation, immunological tolerance, pregnancy complications, placental alkaline phosphatase, exosomes.

For citation: Rudenko Е.Е., Trifonova N.S., Demura Т.А., Zharkov N.V., Kogan E.A., Zhukova E.V., Aleksandrov L.S. The role of placental exosomes in the development of pregnancy complications. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2018; 17(2): 89–96.
DOI: 10.20953/1726-1678-2018-2-89-96