Circulating angiogenic factors and preeclampsia : a possible predictive and prognostic role

Abstract EN

Background / Aim : Previous reports have shown that maternal serum concentrations of soluble fms-like tyrosine kinase 1 (sFlt-1), vascular endothelial growth factor (VEGF), soluble Endoglin (sEng) and placental growth factor (PlGF) are altered in pre-eclamptic (PE) women.

The objective of this study was to find out the potential utility of sEng, sFlt1, PlGF in the pathogenesis, prediction and prognosis of PE by determining the concentrations of these biomarkers in pregnant women who subsequently developed PE and to examine the correlations between these biomarkers and the severity of PE.

Materials and Methods : Samples were collected from 550 pregnant women with singleton pregnancy at 20-24 weeks of gestation, out of them 39 developed preeclampsia, 17 with mild PE, 22 with severe PE.

15 were taken as healthy pregnant controls.

Samples were collected again at 32-37 weeks of gestation only from those who developed PE.

Serum levels of sEng, PlGF and sFlt1 were determined. Results : At 20 through 24 weeks of gestation, sEng was significantly higher in those who developed severe than mild PE, significantly higher in those who developed severe and mild PE than in control group.

There were no significant differences between serum levels of sFlt-1, PlGF, and sFlt-1 / PIGF ratio between severe and mild PE patients.

Levels of sFlt-1, sFlt-1 / PIGF were significantly higher in severe and mild PE than in control group, while that of PIGF were significantly lower in severe and mild PE than in controls.

At 32 through 37 weeks of gestation, sEng, sFlt-1, sFlt-1 / PIGF were significantly higher in severe than in mild PE patients and significantly higher in severe and mild preeclampsia than in control group.

While those of PIGF were significantly lower in severe than in mild PE patients, and significantly lower in severe and mild PE than controls.

In PE patients, there was a significant negative correlation between sFlt-1and PlGF and a positive correlation between sEng and mean arterial blood pressure, sFlt-1 / PlGF and 24 hour albuminuria, sFlt-1 / PlGF and sEng.

Conclusion : Circulating levels of soluble endoglin increase markedly before the onset of preeclampsia, accompanied by increases in the sFlt1: PlGF ratio.