Impact of gut microbiota dysbiosis in development of preeclampsia: a systematic review

Preeclampsia (PE) is a condition that arises during pregnancy, characterized by the development of hypertension and proteinuria after the ۲۰th week of gestational age. Many possible risk factors are found to be potential predisposing factors of PE including metabolic abnormalities, systemic inflammatory reactions, oxidative stress, vascular endothelial damage and gut microbiota dysbiosis which is defined as a disruption to the microbiome resulting in an imbalance in the microbiota. This review is focused on discussing the possible role of gut flora dysbiosis in the pathophysiology of preeclampsia. Based on PRIMSA checklist a systematic search was performed by two people independently across PubMed, Scopus and Elsevier for English studies from ۲۰۱۹ to ۲۰۲۴ and Google Scholar was utilized for literatures and conference papers. Review articles, case-controls, cross-sectionals were surveyed for this review. Animal studies were executed from selected publications. Keywords were: preeclampsia, gut microbiota, gut dysbiosis, trimethylamine N-oxide and their related terminology. The findings indicated that the diversity of gut microbiota in patients with PE is significantly reduced compared to non-PE individuals. Notably, opportunistic pathogens such as Fusobacterium and Veillonella were found to be enriched, while beneficial bacteria like Faecalibacterium and Akkermansia were significantly diminished in the PE patients. Furthermore, gut dysbiosis appears to be linked to an increased production of trimethylamine N-oxide, which correlates with the symptoms of PE. Additionally, analyses of serum inflammatory markers and blood test results revealed that patients with PE exhibited markedly elevated white blood cell (WBC) counts, interleukin-۶ (IL-۶), and tumor necrosis factor-alpha (TNF-α) levels, alongside significantly reduced serum levels of interleukin-۴ (IL-۴) when compared to non-PE individuals. Gut flora dysbiosis may be one of the participants in development of PE. A potential strategy for treating and preventing PE could involve managing gut flora balance, regulating inflammatory components. Regarding to limitation of data more studies are needed to validate and extend these findings.

کلیدواژه ها:

Preeclampsia ، Gut microbiota ، Gut dysbiosis ، Trimethylamine N-oxide