Exosomes in preeclampsia

Preeclampsia (PE) is a multifactorial pregnancy disorder marked by new-onset hypertension after 20 weeks of gestation, often accompanied by proteinuria or organ dysfunction. Affecting 4–6 % of pregnancies globally, PE remains a leading cause of maternal and fetal morbidity. While its precise etiology is not fully understood, growing evidence implicates extracellular vesicles—particularly exosomes—in its pathogenesis. These nanoscale vesicles facilitate intercellular communication by transporting bioactive molecules, including proteins, lipids, and non-coding RNAs (ncRNAs) such as miRNAs, lncRNAs, and circRNAs. In PE, placental exosomes show altered profiles that contribute to endothelial dysfunction, immune imbalance, and impaired angiogenesis. This review synthesizes current knowledge on exosome biogenesis, their diagnostic utility—especially exosomal ncRNAs as non-invasive biomarkers—and emerging therapeutic strategies, including engineered exosomes for targeted delivery. Our findings highlight the promise of exosomes as precision medicine tools in PE management.