Understanding the Neuropathological Link Between Preeclampsia and Neuroinflammation, Neurovascular Damage: Vesna Garovic, MD, PhD

WATCH TIME: 4 minutes

“When we studied [extracellular vesicles] in the blood of these women, they are expressing a higher rate of amyloid-ß compared with the normotensive pregnancies only. Knowing its role in Alzheimer disease, we were amazed by these findings ourselves.”

To better understand the long-term neuroimmunological effects of preeclampsia (PE), a pregnancy-specific hypertensive disorder, a recent study matched 40 women with a history of normotensive pregnancies to 40 age- and parity-matched women with mild (n = 33) and severe PE (n = 7). Blood-borne circulating extracellular vesicles (EVs) derived from neurovascular cellular activation were determined by standardized digital flow cytometry, while plasma concentration of amyloid-ß was measured by ELISA.

Findings indicated that women with a severe history of PE had a significantly higher concentration of amyloid-ß carrying EVs compared with controls (P = .003), as well as those with a history of mild PE (P = .037). Additionally, EVs positive for the markers of blood-brain barrier-endothelial damage and inflammatory coagulation pathway activator were significantly higher in severe PE cases vs controls (P = .008 and P = .002, respectively). Senior investigator Vesna Garovic, MD, PhD, sat down with NeurologyLive® to detail these findings.

Garovic, a nephrologist at Mayo Clinic, provided insight on the previous studies that led to this research, the biggest take-home points from the new data, and the next steps in further building on these findings.

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REFERENCES
1. Suvokov S, Norby A, Abou-Hassan C, et al. Circulating extracellular vesicles of neurovascular origin are elevated in women with severe preeclampsia years after their affected pregnancies. Presented at: 2022 Alzheimer’s Association International Conference; July 31 to Aug 4; San Diego, CA. 62360
2. Raman MR, Tosakulong N, Zuk S, et al. influence of preeclampsia and late-life hypertension on MRI measures of cortical atrophy. J Hypertens. 2017;35(12)2479-2485. doi:10.1097/HJH. 0000000000001492.