The Levels of Circulating Vascular Endothelial Growth Factor and Soluble Flt-1 in Pregnancies Complicated by Preeclampsia

Abstract

To evaluate the role of vascular endothelial growth factor (VEGF) in the pathogenesis of preeclampsia, we measured total VEGF, free VEGF and soluble Flt-1 (sFlt-1) concentrations and determined their relationships. Maternal serum samples were collected from 20 patients with preeclampsia and 20 normotensive women with uncomplicated pregnancies matched with the patients with preeclampsia for gestational age and parity. The serum concentrations of total VEGF (2.39±0.75 vs. 0.28±0.14) and sFlt-1 (934.5±235.5 vs. 298.0±161.2) were significantly increased in the patients with preeclampsia compared to the women with uncomplicated pregnancies. However the serum concentration of free VEGF (21.5±6.3 vs. 134.0±16.3) was lower in patients with preeclampsia. There was a positive correlation between the serum concentrations of total VEGF and sFlt-1 with systolic and diastolic blood pressure, respectively. There was a negative correlation between the serum concentration of free VEGF and systolic and diastolic blood pressure. There was a strong negative correlation between free VEGF and sFlt-1 concentrations. In conclusion, we found VEGF and sFlt-1 were related to the pathogenesis of preeclampsia. Although reduced concentrations of free VEGF might interfere with endothelial cell function and survival, further studies are required to clarify its specific role in the pathogenesis of preeclampsia.

Circulating angiogenic factors and their association with birth outcomes in preeclampsia

“…A similar decrease in free maternal VEGF levels has also been reported by others. 8,31 It has been suggested that VEGF is responsible for the adequate perfusion of the feto-placental unit, normal fetal oxygenation, nutrition and appropriate intrauterine fetal growth; 9 the reduced VEGF levels observed in our study are similar to those found in other studies. [6][7][8][9] Reduced PlGF levels have been suggested to be a result of inadequate placental production, 12 which has been previously reported.…”

“…8,31 It has been suggested that VEGF is responsible for the adequate perfusion of the feto-placental unit, normal fetal oxygenation, nutrition and appropriate intrauterine fetal growth; 9 the reduced VEGF levels observed in our study are similar to those found in other studies. [6][7][8][9] Reduced PlGF levels have been suggested to be a result of inadequate placental production, 12 which has been previously reported. 7,32 Qazi et al 33 have examined the circulating levels of VEGF and sFlt-1 and suggested that decreased VEGF levels resulting from elevated sFlt-1 might be a potential cause of the pathogenesis of preeclampsia.…”

“…Several studies carried out in Western countries have consistently reported increased levels of plasma sFlt-1 8,15,[34][35][36][37][38][39][40][41] in mothers with preeclampsia compared with normotensive women. Our results suggest that Indian women with preeclampsia also have a similar increase in plasma sFlt-1 levels.…”

“…4 Recent studies suggest that dysregulation of angiogenic factors and their soluble fmslike tyrosine kinase-1 receptors (sFlt-1) has an important role in the pathogenesis of preeclampsia, but the results are inconsistent. Although some studies report lower plasma vascular endothelial growth factor (VEGF) levels 5 in preeclamptic women compared with normotensive women, [6][7][8][9] other studies report higher levels in preeclamptic women, 10,11 and some found no difference between the two groups. 5 Placental growth factor (PlGF) is a placental protein that potentiates the effect of VEGF.…”

VEGF and its soluble receptor VEGFR-2 in hypertensive disorders during pregnancy: the Indian scenario

“…Besides angiogenesis, VEGF is believed to increase microvascular permeability and also promote coagulation in PIH disorders. 22 Several studies have demonstrated significantly elevated circulating VEGF concentration in women with PE; 23 however; recent studies have demonstrated decreased biologically active free VEGF concentrations in women with PE. 24 In this study, we observed that there was no change in VEGF levels in the complete control group, early weeks of GH and PE group, but these free VEGF levels were significantly elevated in late GH (P ¼ 0.0001), late PE (P ¼ 0.0001) and early (P ¼ 0.0001) and late (P ¼ 0.0001) eclampsia pregnant groups as compared with the control group, suggesting altered VEGF concentrations according to severity of these disorders.…”