Abstract
Preeclampsia (PE) is a multi-organ pregnancy complication accompanied by significant changes in the central nervous system. Neurological disorders in PE include headache, seizures, cognitive impairment, stroke, and posterior reversible encephalopathy syndrome (PRES). In recent years, increasing attention has been paid to the search for objective laboratory biomarkers reflecting the degree of neuronal and glial damage. Among these, neuronal proteins - GFAP, NfL, S100B, and NSE - have gained particular importance, reflecting different types of brain tissue damage. This review summarizes current literature data on the role of these markers in preeclampsia and their potential in diagnosis and prediction of neurological complications.
References
1. Abalos E. et al. Global and regional estimates of preeclampsia and eclampsia. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):1–7.
2. GBD 2019 Diseases and Injuries Collaborators. Global Burden of Disease Study 2019. Lancet. 2020.
3. Roberts J.M., Hubel C.A. The two-stage model of preeclampsia. Placenta. 2009;30(Suppl A):S32–S37.
4. Rana S. et al. Preeclampsia: pathophysiology, challenges, and perspectives. Circ Res. 2019;124(7):1094–1112.
5. Cipolla M.J. Cerebrovascular function in pregnancy and eclampsia. Hypertension. 2007;50(1):14–24.
6. Brewer J. et al. Posterior reversible encephalopathy syndrome in 46 of 47 patients with eclampsia. Am J Obstet Gynecol. 2013;208(6):468.e1–468.e6.
7. Bartynski W.S. Posterior reversible encephalopathy syndrome. AJNR Am J Neuroradiol. 2008;29(6):1036–1042.
8. Postma I.R. et al. Long-term consequences of eclampsia. Eur J Obstet Gynecol Reprod Biol. 2014;181:75–79.
9. Zeisler H. et al. Predictive value of the sFlt-1:PlGF ratio in preeclampsia. N Engl J Med. 2016;374(1):13–22.
10. Burton G.J. et al. Pre-eclampsia: pathophysiology and clinical implications. BMJ. 2019;366:l2381.
11. Levine D.A. et al. Circulating biomarkers of neuronal injury in preeclampsia. Stroke. 2021;52(5):1742–1751.
12. Mondal S. et al. Serum GFAP as a biomarker for cerebral damage in severe preeclampsia and eclampsia. Pregnancy Hypertens. 2021;24:53–59.
13. Zetterberg H., Blennow K. Neurofilament light: a universal biomarker for axonal integrity. Lancet Neurol. 2020;19(8):639–649.
14. Gaetani L. et al. Neurofilament light chain as biomarker in neurological disorders. Nat Rev Neurol. 2019;15:547–561.
15. Janelidze S. et al. Plasma GFAP in preeclampsia and eclampsia. JAMA Neurol. 2021.
16. Thelin E.P. et al. NfL as marker of neuronal damage. Brain. 2017;140:2322–2333.
17. Barro C., Benkert P., Disanto G. et al. Serum NfL in neurological disease. Neurology. 2018;90(13):e1231–e1239.
18. Levine D.A. et al. Circulating neuronal biomarkers in hypertensive pregnancy disorders. Stroke. 2021;52(5):1742–1751.
19. Hansen S. et al. NfL and GFAP levels in preeclampsia: a pilot study. J Hypertens. 2022;40(7):1320–1329.
20. S100B as marker of BBB disruption. Clin Chim Acta. 2019;495:228–233.


