An essay of reflection: Why does preeclampsia exist in humans, and why are there such huge geographical differences in epidemiology?

- Why preeclampsia exists in the human species?
- A summary of major advances in the immunology of implantation over the last decade.
- Possible future treatments for maternal vascular disease.
- Epidemiological international comparisons between geographical areas.

This workshop had four main objectives: (A) Trying to look at the preeclampsia (PE) problem “from the Space Shuttle”: why preeclampsia has emerged in humans (a specific human reproductive feature among 4300 mammal species)? (B) Epidemiology: there are major geographical differences concerning early onset PE and late onset PE throughout the world. (C) Vascular: The very promising use of pravastatin in the treatment of the vascular maternal syndrome (based on the metabolism of carbon monoxide (CO), the role of inositol phosphate glycans P-type (IPG-P), a major role in comprehending the insulin resistance phenotype in preeclampsia. (D) Immunology: the specialty of these workshops since their start in 1998; our understanding of the role of the immune system and the regulation of the deep implantation of the human trophoblast (and the obligatory compromises between the fetal/placental unit and the mother) have reached a kind of “maturity,” following the pivotal studies exploring the biology of repetitive sperm exposure in the female genital tract. The meeting of people who never meet each other in the course of their normal professional lives (obstetricians, evolutionists, geneticists, immunologists, fundamentalist vascular biologists, epidemiologists, anthropologists, neonatologists, etc.) permitted some fruitful reflections to be made again this year.