Evaluation of agreement of placental growth factor (PlGF) tests and the soluble FMS-like tyrosine kinase 1 (sFlt-1)/PlGF ratio, comparison of predictive accuracy for pre-eclampsia, and relation to uterine artery Doppler and response to aspirin

Navaratnam, Kate; Abreu, Patrícia; Clarke, H.; Jorgensen, Andrea; Alfirevic, Ana; Alfirević, Z̄arko

doi:10.1080/14767058.2017.1373760

Cited by 10 publications

(8 citation statements)

References 23 publications

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“…The interpretation of this finding according to the investigators was that aspirin could be efficacious through other pathways other than altering the levels of angiogenic factors [86]. Another recent study did not find an association between every form of adherence to aspirin therapy and abnormal angiogenic markers [87]. Therefore, future studies are required to further investigate the effect of aspirin on circulating levels of angiogenic factors in different racial/population groups.…”

Section: Discussionmentioning

confidence: 99%

The performance of pre-delivery serum concentrations of angiogenic factors in predicting postpartum antihypertensive drug therapy following abdominal delivery in severe preeclampsia and normotensive pregnancy

2019

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Background The imbalance between circulating concentrations of anti- and pro-angiogenic factors is usually intense in preeclampsia with severe features (sPE). It is possible that pre-delivery circulating levels of angiogenic factors in sPE may be associated with postpartum antihypertensive drug requirements. Objective To determine the predictive association between maternal pre-delivery serum concentrations of angiogenic factors and the use of ≥3 slow- and/or a rapid-acting antihypertensive drug therapy in sPE on postpartum days zero to three following caesarean delivery. Study design Women with sPE (n = 50) and normotensive pregnancies (n = 90) were recruited prior to childbirth. Serum samples were obtained from each participant < 48 hours before delivery to assess the concentrations of placental growth factor (PIGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) using the Roche Elecsys platform. Each participant was followed up on postpartum days zero, one, two and three to monitor BP and confirm antihypertensive treatment. The optimal cut-off thresholds of sFlt-1/PIGF ratio from receiver operating characteristic curve predictive of the antihypertensive therapy were subjected to diagnostic accuracy assessment. Results The majority 58% (29/50) of sPE had multiple severe features of preeclampsia in the antenatal period with the commonest presentation being severe hypertension in 88% (44/50) of this group, followed by features of impending eclampsia which occurred in 42% (21/50). The median gestational age at delivery was 38 (Interquartile range, IQR 1) vs 36 (IQR 6) weeks, p < 0.001 in normotensive and sPE groups respectively. Notably, the median sFlt-1/PIGF ratio in normotensive and sPE groups were 7.3 (IQR 17.9) and 179.1 (IQR 271.2) respectively, p < 0.001. Of the 50 sPE participants, 34% (17/50) had early-onset preeclampsia. The median (IQR) of sFlt-1/PIGF in the early- and late-onset preeclampsia groups were 313.52 (502.25), and 166.59(195.37) respectively, p = 0.006. From postpartum days zero to three, 48% (24/50) of sPE received ≥ 3 slow- and/or a rapid-acting antihypertensive drug. However, the daily administration of ≥ 3 slow- and/or a rapid-acting antihypertensive drug in sPE were pre-delivery 26% (13/50), postpartum day zero 18% (9/50), postpartum day one 34% (17/50), postpartum day two 24% (12/50) and postpartum day three 20% (10/50). In sPE, the pre-delivery sFlt-1/PIGF ratio was predictive of administration of ≥3 slow- and/or a rapid-acting antihypertensive drug on postpartum days zero, one and two with the optimal cut-off ratio being ≥315.0, ≥181.5 and ≥ 267.8 respectively (sensitivity 72.7–75.0%, specificity 64.7–78.6%, positive predictive value 40.0–50.0% and negative predictive value 84.6% - 94.3%). The predictive performance of sFlt-1/PIG ratio on postpartum day 3 among the sPE was no...

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Section: Discussionmentioning

confidence: 99%

The performance of pre-delivery serum concentrations of angiogenic factors in predicting postpartum antihypertensive drug therapy following abdominal delivery in severe preeclampsia and normotensive pregnancy

2019

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“…Previous studies have found that overexpression of sFlt-1 induces a preeclampsia–like phenotype, which includes increased BP, proteinuria, and endothelial dysfunction ( Caillon et al 2018 ). Also, it has been demonstrated that increased sFlt-1 will lead to a more severe preeclampsia-like phenotype in eNOS −/− mice ( Navaratnam et al 2017 ). Symptoms including the increase of UAE, the decrease of CCr, and more severe endotheliosis are aggravated by a synergistic effect combining the overexpression of sFlt-1 and the depletion of eNOS.…”

Section: Discussionmentioning

confidence: 99%

Deletion of GIT1 Impacts eNOS Activity To Aggravate sFlt-1–Induced Preeclampsia Phenotype in Mice

Zhang

Zou

Zhang

2018

G3 Genes|Genomes|Genetics

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Preeclampsia, a serious multisystem disorder specific to human pregnancy, remains a considerable burden of disease worldwide. Reduced nitric oxide bioavailability is proved to be crucial in the maternal and fetal pathophysiology of preeclampsia. G-protein-coupled Receptor Kinase Interactor-1 (GIT1) is a novel endothelial nitric oxide synthases (eNOS) interactor mediator. The aim of this paper is to investigate the effect of GIT1 on preeclampsia. Blood pressure (BP) was measured using a carotid catheter-calibrated eight-chamber tail-cuff system (CODA) at the same time daily. Urinary albumin excretion (UAE) was determined using Albuwell-M kits (Exocell Inc) and creatinine clearance (CCr) was determined by measuring urinary creatinine concentration with tandem liquid chromatography–mass spectrometry. The release of nitrite was analyzed to detect nitric oxide (NO) production using a Sievers Chemiluminescence NO Analyzer. NOS activity was examined by measuring the conversion of 3H-labeled l-arginine to 3H-labeled l-citrulline. BP was significantly increased in GIT1−/− mice with or without sFIT-1 treatment. In addition, GIT1−/− mice possessed higher UAE and lower CCr. Depletion of GIT1 impedes the NO production and placenta eNOS activity. Additional GIT1 attenuates sFlt-1-induced preeclampsia phenotypes. Our findings suggest that GIT1 significantly extenuates the sFlt-1-induced preeclampsia phenotypes by inhibiting eNOS activity, indicating a crucial role of GIT1 in the progression of preeclampsia.

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“…Results of longitudinal study conducted by Porto and coworkers indicated that all pregnancies complicated with early onset of preeclampsia have had significantly higher uterine artery PI between 16+0 and 19+6 weeks of gestation (26). Navaratnam and colleagues went a step further, and compared PlGF tests and the sFlt-1/PlGF ratio with abnormal uterine artery Doppler (27). Results of their investigation showed significant association between PlGF or sFlt-1/PlGF ratio with results of Doppler parameters.…”

Section: Uterine Artery Doppler In Preeclampsia Predictionmentioning

confidence: 99%

Preeclampsia – Prediction and Monitoring Factors

Rudic

Raičević

Babić

2019

Serbian Journal of Experimental and Clinical Research

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Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality, usually characterized by hypertension and proteinuria. Despite high incidence of preeclampsia the pathophysiological basis of preeclampsia is still not clear and there are a number of mechanisms and signaling pathways that intertwine. It is very important to develop specific and reliable predictive algorithms in order to enable early initiation of therapy due to facts that incidence of preeclampsia has upward trend and that cause adverse maternal and fetal outcome. Some of the most commonly used methods for prediction of preeclampsia include uterine artery Doppler velocimetry, determination of some microRNA, such as miR-210, and assessment of various pro-angiogenic and anti-angiogenic factors from blood. Angiogenic factors that possibly have most important role in pathogenesis of preeclampsia are vascular endothelial growth factor (VEGF) and placental growth factor (PlGF), which promote angiogenesis, and soluble fms-like tyrosine kinase-1 (sFlt1) and soluble form of endoglin (s-Eng), which exhibit anti-angiogenic properties. Aggravating circumstance is that preeclampsia has heterogeneous origin, and due to this fact, the value of individual markers can vary significantly. There is a constant tendency for creating comprehensive algorithm for prediction of preeclampsia which would be sufficiently specific and sensitive, and in the same time cheap and available. In that sense, new clinical studies are needed to show the most effective combination of parameters in the predeclampsia prediction.

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Evaluation of agreement of placental growth factor (PlGF) tests and the soluble FMS-like tyrosine kinase 1 (sFlt-1)/PlGF ratio, comparison of predictive accuracy for pre-eclampsia, and relation to uterine artery Doppler and response to aspirin

Cited by 10 publications

References 23 publications

The performance of pre-delivery serum concentrations of angiogenic factors in predicting postpartum antihypertensive drug therapy following abdominal delivery in severe preeclampsia and normotensive pregnancy

The performance of pre-delivery serum concentrations of angiogenic factors in predicting postpartum antihypertensive drug therapy following abdominal delivery in severe preeclampsia and normotensive pregnancy

Deletion of GIT1 Impacts eNOS Activity To Aggravate sFlt-1–Induced Preeclampsia Phenotype in Mice

Preeclampsia – Prediction and Monitoring Factors

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