The paper is devoted to the results of more than 20-year-long studies made by the author with his disciples on the problem of preeclampsia. A comparative analysis of a large number of clinical observations and data of general and special studies has made it possible to develop and scientifically justify a different concept of preeclampsia development and progression. The paper describes the destructive nature of gestational endothelial damage in this complication of pregnancy. A parallel was drawn between preeclampsia and other immune-mediated diseases, the pathogenesis of which is based on the abnormal activation of complement proteins and a cytokine cascade; the trigger of these processes can be neuron-specific proteins of the developing fetal brain. The proposed concept makes it possible to revise therapeutic approaches to managing patients with preeclampsia and to justify the possibility of targeting the key component of its pathogenesis.

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