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Core Component of Preeclampsia

A potential new therapeutic target and biomarker for preeclampsia now emerges from a study of mice and women [1]. The findings suggest the cytokine Interleukin-11 (IL11) is central to the development of this hard-to-treat disorder. Preeclampsia seems to be caused by abnormal development of the placenta; the condition involves inadequate invasion of trophoblasts into the decidua, and impaired remodeling of uterine spiral arteries. Interleukin-11 (IL11) has previously been implicated in placentation. For instance, it is required for decidualization in humans and mice, and impedes human trophoblast invasion in vitro. IL11 has also been implicated in preeclampsia—e.g., decidual tissue from women with the condition have elevated levels of the cytokine. In the new study, Amy Winship et al. took a closer look at the role of IL11, administering it to mice at implantation sites throughout gestation. This treatment caused mice to develop features of preeclampsia—including impaired placentation, as well as increased systolic blood pressure, intratuterine growth restriction, and elevated circulating protein levels (proteinurea). Curiously, withdrawing IL11 after the onset of symptoms resulted in a return of blood pressure and protein levels to normal, and also normalized some placental defects—all hinting that treatments targeting IL11 may have the potential to be effective after diagnosis of the condition. The researchers also showed that IL11 levels were elevated in serum collected from women before the development of early-onset preeclampsia—suggesting that IL11 has the potential to serve as a badly needed biomarker to aid in early diagnosis. The researchers next examined the mechanism behind IL11 actions. Their findings suggest that IL11 affects the recruitment of immune cells involved in placentation, and that it operates through PAPPA2 (pregnancy-associated plasma protein) and STAT-3. The findings set the stage for future studies exploring the value of IL11 and its molecular effectors as drug targets and biomarkers for preeclampsia. The study also introduces a new mouse model for this common condition, which, in developed countries, causes about 15 to 20 percent of maternal deaths.