The role of sFlt1/PlGF ratio in the assessment of preeclampsia and pregnancy-related hypertensive disorders

Abstract

Preeclampsia is a major cause of maternal and fetal morbidity and mortality. Early recognition of the disease may be challenging. Complications may precede the onset of clinical symptoms and medical intervention is often delayed. Moreover, in the absence of specific clinical signs, many patients will present symptoms mimicking the disease without ever being diagnosed with preeclampsia. This situation may, however, lead to medical interventions and cause unnecessary stress for the patient. For many years, research tried to evaluate the significance of serum biomarkers as early indicators of preeclampsia. Among many, the sFlt-1/PlGF ratio, given its performance, aroused the greatest interest. This article reviews current knowledge on the subject, focusing on a Swiss perspective.

Assessing the Role of Uric Acid as a Predictor of Preeclampsia

“…So far, several promising biomarkers that could be used to make an early diagnosis have been identified. Antiangiogenic factors such as soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng), as well as pro-angiogenic factors such as vascular endothelial growth factor (VEGF) and placenta growth factor (PIGF) have demonstrated some benefit in the prediction or diagnosis of preeclampsia, as well as in the understanding of its etiology (Huppertz, 2018;McCarthy et al, 2018;Baert et al, 2021;Dröge et al, 2021;Lim et al, 2021). However, the choice of a biomarker should not only be related to its biological characteristics and its participation in the pathogenesis of the disease, but also to the feasibility of being used as a screening tool.…”

Red Light Mitigates the Deteriorating Placental Extracellular Matrix in Late Onset of Preeclampsia and Improves the Trophoblast Behavior

“…sFlt, a truncated version of VEGFR1, is a putative pre-E biomarker because its release is increased in pre-E [ 7 , 8 ]. We characterized pre-E by measuring sFlt levels with ELISA ( Figure 1 ).…”

Early increase in circulating carbonic anhydrase IX: A potential new predictive biomarker of preeclampsia

“…At the moment, the pathogenesis of PE is not fully defined. However, the imbalance between angiogenic factors like VEGF or PlGF and anti-angiogenic factors like sFlt1 released in the circulation by the placenta is known to be involved in the disease development (Baert et al, 2021;Verlohren et al, 2022). Thus, these markers, alone or combined, could be used for the management of suspected preeclampsia.…”

“…In overt preeclampsia, the ratio has a high sensitivity (99.5% or 95.5% in women before the 34th gestational week or after, respectively). The values of the sFlt1/PlGF plasma ratio >85 before 34 weeks or >110 after 34 weeks of gestation are those recommended in the current clinical practice as alert values ( Baert et al, 2021 ). In our previous study, we explored longitudinally throughout gestation some possible predictive mRNA biomarkers of PE in a high-risk population, involving different pathogenic pathways including endothelial damage.…”