Renal Injury during Preclampsia: Role of Extracellular Vesicles

Preeclampsia (PE) represents an important cause of acute kidney injury during pregnancy with a high rate of both maternal and fetal morbidity and mortality. The presence of endothelial dysfunction is the main cause of PE development; however, the pathogenic mechanisms are not still fully elucidated. A plethora of harmful mediators are released in response to endothelial damage: these circulating molecules (soluble fms-like tyrosine kinase 1, endothelin-1) can exert antiangiogenic and vasoconstrictive effects on distant organs including the kidney. In this scenario, extracellular vesicles (EVs), microparticles released by different types of activated cells and involved in intercellular communication, are produced both in normal pregnancy and PE. The aim of this review is to summarize the modern concepts of PE-associated kidney damage and the potential role of EV in these detrimental mechanisms.