Early-onset pre-eclampsia is recognized as a placental disease, featuring vascular lesions with a reduced blood supply.27 The current data showing higher levels of circulating nectin-4 in cases with early-onset pre-eclampsia, combined with its abundant expression in villous trophoblasts in the pre-eclamptic placenta, suggest that upregulation of nectin-4 expression may be involved in the etiology of pre-eclampsia, particularly in early-onset disease.13,16. This evidence concerns the gene NECTIN4 and placenta disorder.