Placental exosomes in normal and complicated pregnancy

Murray D. Mitchell, Hassendrini N. Peiris, Miharu Kobayashi, Yong Q. Koh, Gregory Duncombe, Sebastian E. Illanes, Gregory E. Rice, Carlos Salomon*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

280 Scopus citations


While there is considerable contemporary interest in elucidating the role of placenta-derived extracellular vesicles in normal and complicated pregnancies and their utility as biomarkers and therapeutic interventions, progress in the field is hindered by a lack of standardized extracellular vesicle taxonomy and isolation protocols. The term "extracellular vesicle" is nonspecific and refers to all membrane-bound vesicles from nanometer to micrometer diameters and of different biogenic origins. To meaningfully ascribe biological function and/or diagnostic and therapeutic utility to extracellular vesicles, and in particular exosomes, greater specificity and vesicle characterization is required. The current literature relating to exosome biology must be interpreted in this context. Exosomes are a subtype of extracellular vesicle that are specifically defined by an endosomal biogenesis and particle size (40-120 nm) and density (1.13-1.19 g/mL-1). Exosomes are specifically package with signaling molecules (including protein, messenger RNA, microRNA, and noncoding RNA) and are released by exocytosis into biofluid compartments. Exosomes regulate the activity of both proximal and distal target cells, including translational activity, angiogenesis, proliferation, metabolism, and apoptosis. As such, exosomal signaling represents an integral pathway mediating intercellular communication. During pregnancy, the placenta releases exosomes into the maternal circulation from as early as 6 weeks of gestation. Release is regulated by factors that include both oxygen tension and glucose concentration and correlates with placental mass and perfusion. The concentration of placenta-derived exosomes in maternal plasma increases progressively during gestation. Exosomes isolated from maternal plasma are bioactive in vitro and are incorporated into target cells by endocytosis. While the functional significance of placental exosomes in pregnancy remains to be fully elucidated, available data support a role in normal placental development and maternal immunotolerance. Similarly, the role of exosomes in the etiology and progression of complications of pregnancy remains in a formative stage. Changes in the release of placenta- and nonplacenta-derived exosomes, their concentration in maternal plasma, composition, and bioactivity have been reported in association with pregnancies complicated by gestational diabetes and preeclampsia. The data, however, are confounded by the use of different isolation methodologies and vesicle subpopulations. The application of specific and well-characterized isolation methodologies is requisite to resolving the precise role of exosomes in complications of pregnancies and their ultimate clinical utility.

Original languageEnglish
Pages (from-to)S173-S181
JournalAmerican Journal of Obstetrics and Gynecology
Issue number4
StatePublished - 1 Oct 2015

Bibliographical note

Funding Information:
Dr Salomon holds a research fellowship at the University of Queensland Center for Clinical Research, Brisbane, Australia. Dr Rice received a NHMRC Principal Research Fellowship. Supported by the University of Queensland ; Therapeutics Innovations Australia ; National Collaborative Infrastructure Strategy ; Smart Futures Fund (Department of Employment, Economic Development, and Innovation, Queensland Government); Royal Brisbane and Women’s Hospital Foundation ; Department of Industry, Innovation, Science, Research, and Tertiary Education, Australian Government ; Australian Government Smart Futures Scheme ; and Queensland State Government Smart Futures .

Publisher Copyright:
© 2015 Elsevier Inc.


  • angiogenesis
  • biomarkers
  • cell-to-cell communication
  • microparticles
  • placenta alkaline phosphatase
  • preeclampsia
  • prognostic markers


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