Affinity-Enhanced Multimeric VEGF (Vascular Endothelial Growth Factor) and PlGF (Placental Growth Factor) Variants for Specific Adsorption of sFlt-1 to Restore Angiogenic Balance in Preeclampsia

Matin, Mahsa; Mörgelin, Matthias; Stetefeld, Jörg; Schermer, Bernhard; Brinkkoetter, Paul T.; Benzing, Thomas; Koch, Manuel; Hagmann, Henning

doi:10.1161/hypertensionaha.120.14974

Cited by 17 publications

(15 citation statements)

References 39 publications

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“…More recent experimental therapeutic approaches are investigating the possibility of using apheresis to reduce sFlt-1 levels. A significant reduction in sFlt-1 serum concentrations has been achieved in small pilot studies which showed an alleviation of maternal symptoms including a reduction of maternal hypertension and proteinuria and increased fetal growth based on fetal percentile curves 108 , 109 , 110 . In addition, studies have shown that this delayed immediate delivery of the infant by 2 – 21 days.…”

Section: Specific Causes Of Pr-akimentioning

confidence: 99%

“…Neuere experimentelle Therapieansätze untersuchen die Möglichkeit der Reduktion von sFlt-1 mittels Apherese. In kleineren Pilotstudien ließ sich zum einen eine signifikante sFlt-1-Konzentrations-Senkung im Serum, zum anderen eine Erleichterung der mütterlichen Symptome wie Einstellung des Blutdrucks und Abnahme der Proteinurie als auch ein gesteigertes Wachstum auf der Perzentilenkurve der Feten nachweisen 108 , 109 , 110 . Weiterhin ließ sich eine notwendige sofortige Entbindung um 2 – 21 Tage verzögern.…”

Section: Spezifische Ursachen Des Pr-akiunclassified

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Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management

Scurt

Morgenroth

Bose

et al. 2022

Geburtshilfe Frauenheilkd

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Despite significant improvements in inpatient and outpatient management, pregnancy-related acute kidney injury (Pr-AKI) remains an important risk factor for early and late maternal and fetal morbidity and mortality. There is a discrepancy between the incidence of Pr-AKI in developing and in developed countries, with the former experiencing a decrease and the latter an increase in Pr-AKI in recent decades. Whereas septic and hemorrhagic complications predominated in the past, nowadays hypertensive disorders and thrombotic microangiopathy are the leading causes of Pr-AKI. Modern lifestyles and the availability and widespread use of in-vitro fertilization techniques in industrialized countries have allowed more women of advanced age to become pregnant. This has led to a rise in the percentage of high-risk pregnancies due to the disorders and comorbidities inherent to or accompanying aging, such as diabetes, arterial hypertension and preexisting chronic kidney disease. Last but not least, the heterogeneity of symptoms, the often overlapping clinical and laboratory characteristics and the pathophysiological changes related to pregnancy make the diagnosis and management of Pr-AKI a difficult and challenging task for the treating physician. In addition to general supportive management strategies such as volume substitution, blood pressure control, prevention of seizures or immediate delivery, each disease entity requires a specific therapy to reduce maternal and fetal complications. In this review, we used the current literature to provide a summary of the physiologic and pathophysiologic changes in renal physiology which occur during pregnancy. In the second part, we present common and rare disorders which lead to Pr-AKI and provide an overview of the available treatment options.

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Section: Specific Causes Of Pr-akimentioning

confidence: 99%

Section: Spezifische Ursachen Des Pr-akiunclassified

Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management

Scurt

Morgenroth

Bose

et al. 2022

Geburtshilfe Frauenheilkd

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“…sFlt-1 binds to VEGF and PGF to inhibit their proangiogenic process ( 130 ). sFlt-1/VEGF imbalance leads to endothelial dysfunction and angiogenic disorder in patients with PE ( 131 , 132 ). The sFlt-1/VEGF ratio has emerged as a key biochemical indicator for predicting the risk of PE ( 113 ).…”

Section: Mesenchymal Stem Cells In Preeclampsia Therapymentioning

confidence: 99%

The pathological and therapeutic roles of mesenchymal stem cells in preeclampsia

Jin

Chen³

et al. 2022

Front. Med.

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Mesenchymal stem cells (MSCs) have made progress in the treatment of ischemic and inflammatory diseases. Preeclampsia (PE) is characterized by placenta ischemic and inflammatory injury. Our paper summarized the new role of MSCs in PE pathology and its potency in PE therapy and analyzed its current limitations. Intravenously administered MSCs dominantly distributed in perinatal tissues. There may be additional advantages to using MSCs-based therapies for reproductive disorders. It will provide new ideas for future research in this field.

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“…This hypothesis of the pathophysiology of preeclampsia has led to the development of strategies to restore the angiogenic balance. The removal of sFlt-1 from the circulation by apheresis has shown promising results as a potential treatment of preeclampsia, since increases the levels of free VEGF and PlGF in serum samples of preeclamptic patients ( Matin et al, 2020 ).…”

Section: Is the Endothelial Dysfunction At The Bbb In Preeclampsia A ...mentioning

confidence: 99%

How Soluble Fms-Like Tyrosine Kinase 1 Could Contribute to Blood-Brain Barrier Dysfunction in Preeclampsia?

2022

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Preeclampsia is a pregnancy-related syndrome that courses with severe cerebrovascular complications if not properly managed. Findings from pre-clinical and clinical studies have proposed that the imbalance between pro- and anti-angiogenic factors exhibited in preeclampsia is a major component of its pathophysiology. In this regard, measurement of circulating levels of soluble tyrosine kinase-1 similar to fms (sFlt-1), a decoy receptor for vascular endothelial growth factor (VEGF), is a moderately reliable biomarker for the diagnosis of preeclampsia. However, few studies have established a mechanistic approach to determine how the high levels of sFlt-1 are responsible for the endothelial dysfunction, and even less is known about its effects at the blood-brain barrier (BBB). Since the expression pattern of VEGF receptors type 1 and 2 in brain endothelial cells differs from the observed in peripheral endothelial cells, and components of the neurovascular unit of the BBB provide paracrine secretion of VEGF, this compartmentalization of VEGF signaling could help to see in a different viewpoint the role of sFlt-1 in the development of endothelial dysfunction. In this article, we provide a hypothesis of how sFlt-1 could eventually be a protective factor for brain endothelial cells of the BBB under preeclampsia.

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Affinity-Enhanced Multimeric VEGF (Vascular Endothelial Growth Factor) and PlGF (Placental Growth Factor) Variants for Specific Adsorption of sFlt-1 to Restore Angiogenic Balance in Preeclampsia

Cited by 17 publications

References 39 publications

Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management

Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management

The pathological and therapeutic roles of mesenchymal stem cells in preeclampsia

How Soluble Fms-Like Tyrosine Kinase 1 Could Contribute to Blood-Brain Barrier Dysfunction in Preeclampsia?

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