Modern concepts of preeclampsia, taking into account the role of the permeability of the hematoencephalic barrier

The article presents modern data from the world literature on the nature and essence of preeclampsia as a general pathological specific gestational endotheliosis, the leading role in the pathogenesis of which is played by damage to the endothelium with a change in the functional properties of the blood-brain barrier (BBB) — a violation of its integrity and permeability, including in combination with damage to neurons and glia. An important pathogenetic role of inadequate autoregulation and pathological changes in cerebral perfusion pressure in combination with impaired BBB permeability, leading to vasogenic cerebral edema and eclamptic seizures, has been revealed. A comparative analysis of a large number of clinical observations, general data and special research methods has significantly expanded the understanding of preeclampsia, taking into account the key role of BBB permeability in its development. The purpose of this review is to highlight exactly how the vascular function of the brain and the integrity of the BBB are disrupted in preeclampsia, which makes it possible to improve understanding of the effect of preeclampsia on the brain. New data on the role of the functional properties of BBB open up a different view on the unresolved issues of preeclampsia, allowing us to reconsider the therapeutic possibilities of managing patients with preeclampsia, taking into account the nature of brain damage.