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Preeclampsia (PE) is a multisystem disorder associated with pregnancy and its frequency varies from 5 to 20 percent of pregnancies. Although a number of preeclampsia studies have been carried out, there is no consensus about disease etiology and pathogenesis so far. Peptides of SERPINA1 (&alpha, 1-antitrypsin) in urine remain one of the most promising peptide markers of PE. In this study the diagnostic potential of urinary &alpha, 1-antitrypsin peptides in PE was evaluated. The urinary peptidome composition of 79 pregnant women with preeclampsia (PE), chronic arterial hypertension (CAH), and a control group was investigated. Mann&ndash, Whitney U-test (p &lt, 0.05) revealed seven PE specific SERPINA1 peptides demonstrating 52% sensitivity and 100% specificity. SERPINA1 in urine has been associated with the most severe forms of preeclampsia (p = 0.014), in terms of systolic hypertension (p = 0.01) and proteinuria (p = 0.006). According to Spearman correlation analysis, the normalized intensity of SERPINA1 urinary peptides has a similar diagnostic pattern with known diagnostic PE markers, such as sFLT/PLGF. SERPINA1 peptides were not urinary excreted in superimposed PE (PE with CAH), which is a milder form of PE. An increase in expression of SERPINA1 in the structural elements of the placenta during preeclampsia reflects a protective mechanism against hypoxia. Increased synthesis of SERPINA1 in the trophoblast leads to protein accumulation in fibrinoid deposits. It may block syncytial knots and placenta villi, decreasing trophoblast invasion. Excretion of PE specific SERPINA1 peptides is associated with syncytiotrophoblast membrane destruction degradation and increased SERPINA1 staining. It confirms that the placenta could be the origin of SERPINA1 peptides in urine. Significant correlation (p &lt, 0.05) of SERPINA1 expression in syncytiotrophoblast membrane and cytoplasm with the main clinical parameters of severe PE proves the role of SERPINA1 in PE pathogenesis. Estimation of SERPINA1 peptides in urine can be used as a diagnostic test of the severity of the condition to determine further treatment, particularly the need for urgent surgical delivery.

MicroRNAs (miRs) are the class of short nucleotide sequences (21-27 nucleotides) RNA, non-coding protein synthesis. miRs are known as effective posttranscriptional negative regulators of gene expression with specific binding sites of targeted messenger RNA (mRNA) in the cytoplasm, providing translational repression or degradation of the target miR transcript. In this review we studied the role of miRNAs in the development of a physiological pregnancy and obstetric complications. The placenta is a unique organ which provides modulation of the immune system of the maternal organism during pregnancy including miRs which determine immunological tolerance of the body to the tissues of the fetus. Thus the "placental" miRs in maternal circulation may be the potential biomarker revealed at various obstetric pathology on the early stages before clinical manifestation of the diseases.