This article presents a review of scientific literature concerning adverse effect of tobacco smoking on concentration of the pregnancy-associated plasma protein A (PAPP-A) in pregnant women. PAPP-A is produced in great amounts during pregnancy by the syncytiotrofoblast, but can be also detected in a variety of cell types such as fibroblasts, osteoblasts and vascular smooth muscle cells (VSMC). We describe the structure of PAPP-A and its function as an insulin-like growth factor binding proteins (IGFBPs) protease with a focus on data obtained in tobacco smoking pregnant women. We also discuss the results of studies indicating a correlation between smoking and deficit of PAPP-A in the first trimester of pregnancy. The review summarizes possible mechanisms relating tobacco smoking to the changes of PAPP-A concentration during pregnancy.
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