PlGF, sFlt-1 and sFlt-1/PlGF ratio: Promising markers for predicting pre-eclampsia

Abstract

Pre-eclampsia is a hypertensive disorder complicating 5-8% of pregnancies [1]. It is characterized by hypertension and proteinuria and is a leading cause of maternal mortality in 15-20% of pregnant women in developed countries versus 40-80% in developing countries [2,3]. Pre-eclampsia is a state of angiogenic imbalance associated with endothelial dysfunction within specifi c vascular beds (4). The abnormalities in the development of the placental vasculature could occur early, weeks to months before the development of the clinical manifestations of pre-eclampsia [5]. Placental growth factor (PlGF), a member of the vascular endothelial growth factor (VEGF) family, is one of the main factors that play a key role in the remodeling process of maternal arteries in normal pregnancy. This growth factor is released into the bloodstream by the migrating trophoblasts [6]. The soluble fms-like tyrosine kinase-1 (sFlt-1), also known as soluble VEGF receptor-1, is a variant of the VEGF receptor, which is secreted from endothelial cells, monocytes, and placenta. The sFlt-1 is capable of binding with both VEGF and PlGF, consequently regulating their action [7]. Alterations in maternal serum concentrations of PlGF and sFlt-1 have been reported to precede the onset of clinically identifi able preeclampsia as early as the fi rst trimester [6]. The aim of our study is to assess the clinical utility of PlGF and sFlt-1 as early predictors of preeclampsia.

Prenatal screening for preeclampsia: the roles of placental growth factor and pregnancy–associated plasma protein A in the first trimester and placental growth factor and soluble fms-like tyrosine kinase 1–placental growth factor ratio in the early second trimester

“… 11 Publications studying the usefulness of the sFlt-1–PlGF ratio in the early second trimester have yielded inconsistent results. 12 , 13 This study will also assess whether and how early the sFlt-1–PlGF ratio test can be used for PE prediction and if variations in the concentrations of PlGF in the first and second trimesters can provide useful information for PE prediction. The results of the study will provide useful evidence for the implementation of PE screening and the optimization of the patient care pathway.…”