The sFlt-1/PlGF ratio values within the &lt;38, 38–85 and &gt;85 brackets as compared to perinatal outcomes

Bednarek-Jędrzejek, Magdalena; Kwiatkowski, Sebastian; Ksel-Hryciów, Joanna; Tousty, Piotr; Nurek, Karolina; Kwiatkowska, Ewa; Cymbaluk‐Płoska, Aneta; Torbé, Andrzej

doi:10.1515/jpm-2019-0019

Cited by 20 publications

(17 citation statements)

References 21 publications

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“…Virtanen et al observed an inhibitory effect on tubule formation in third trimester preeclamptic women 17 . Serum concentrations of angiogenic factors sFlt-1 levels were higher and PlGF were lower in third trimester preeclamptic women compared to healthy controls with increasing sFlt-1/PlGF ratio between the first and the third trimester 18 . Unfortunately, sFlt-1 and PlGF have limited sensitivity for stratification of women with suspected PE 19 .…”

Section: Discussionmentioning

confidence: 81%

Cerebrospinal beta-amyloid peptides(1-40) and (1-42) in severe preeclampsia and HELLP syndrome – a pilot study

Lederer

Schaffenrath

Alomar-Dominguez

et al. 2020

Sci Rep

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During pregnancy, substantial alterations in cerebral plasticity, vascular remodeling and neuronal growth occur in the maternal brain. We investigated whether concentrations of selected neurodiagnostic biomarkers in the cerebrospinal fluid of women with preeclampsia/HELLP syndrome differ from those in healthy controls using enzyme-linked immunosorbent assay technique. We found that tau protein concentrations (p = 0.016) and phospho-tau/tau ratio (p < 0.001) in cerebrospinal fluid were significantly lower in 39 preeclamptic women compared to 44 healthy controls during third trimester of pregnancy. Beta-amyloid(1-40)/(1-42) ratio was significantly higher in HELLP syndrome than in severe preeclampsia (8.49 + 2.73 vs. 4.71 + 1.65; p = 0.007). We conclude that betaamyloid(1-40)/(1-42) ratio in cerebrospinal fluid can discriminate severe preeclampsia and HELLP syndrome. High beta-amyloid peptide and low tau protein concentrations are associated with impaired development of the materno-feto-placental unit and correlate with placental dysfunction. During pregnancy, the invasion of trophoblast cells into maternal tissue of the uterus and the conversion of spiral arteries into wide sinusoids with low resistance and high flow are paramount for normal placental development 1. In preeclampsia (PE) placental development is impaired by defective deep placentation, platelet and thrombin activation, intravascular inflammation, endothelial dysfunction and imbalanced angiogenesis 2. Altered expression of proteins comes along with excess of antiangiogenic substances such as soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) and decreased levels of proangiogenic substances like placental growth factor (PlGF) and vascular endothelial growth factor A (VEGF-A) 3. Ciampa et al. observed in 13 patients with PE altered concentrations of proteins related to signaling pathways important for vascular remodeling, inflammation, and neuronal growth 4. Recent studies have shown that PE shares pathophysiologic features with recognized misfolding disorders and aggregation of proteins 4-8. There are several dysregulated proteins in PE but it is not clear whether aggregated proteins induce defective trophoblast invasion 4. D'Souza et al. reported that neurotrophic factors influence the development of the materno-feto-placental unit during pregnancy 9. Altered blood-brain barrier and impaired cerebral autoregulation may affect erebral blood flow in the maternal brain 10. Aggregated beta-amyloid peptides were observed in PE as well as in Alzheimer's disease 7. The presence of beta-amyloid aggregates in placentas of women with PE and intrauterine growth restriction (IUGR) further supports the notion that this condition goes with protein conformational disorders 6,11. Moreover, it was observed that short peptides occupying the self-recognition sites of beta-amyloid inhibit beta-amyloid aggregation 8. The aim of this study was to determine whether CSF concentrations of beta-amyloid peptides and tau protein differ between women with PE...

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Section: Discussionmentioning

confidence: 81%

Cerebrospinal beta-amyloid peptides(1-40) and (1-42) in severe preeclampsia and HELLP syndrome – a pilot study

Lederer

Schaffenrath

Alomar-Dominguez

et al. 2020

Sci Rep

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“…Relation between increased sFlt-1/PlGf ratio and adverse neonatal outcome was reported by several authors [12][13][14][15]. Garcia-Manau et al observed sFlt-1/PlGF values and pregnancy outcomes among early-onset SGA/FGR.…”

Section: Discussionmentioning

confidence: 82%

sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates

Witwicki

Chaberek²,

Szymecka-Samaha³

et al. 2021

Children

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Background: Small for gestational age is a pregnancy complication associated with a variety of adverse perinatal outcomes. The aim of the study was to investigate if sFlt-1/PlGF ratio is related to adverse short-term neonatal outcome in neonates small for gestational age in normotensive pregnancy. Methods: A prospective observational study was conducted. Serum sFlt-1/PlGF ratio was measured in women in singleton gestation diagnosed with fetus small for gestational age. Short-term neonatal outcome analyzed in the period between birth and discharge home. Results: Eighty-two women were included. Women with sFlt-1/PlGF ratio ≥33 gave birth to neonates with lower birthweight at lower gestational age. Neonates from high ratio group suffered from respiratory disorders and NEC significantly more often. They were hospitalized at NICU more often and were discharged home significantly later. sFlt-1/PlGF ratio predicted combined neonatal outcome with sensitivity of 73% and specificity of 82.2%. Conclusions: sFlt-1/PlGF ratio is a useful toll in prediction of short-term adverse neonatal outcome in SGA pregnancies.

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“…There were no significant differences between both groups with regard to APO, including lower neonatal birth weight and umbilical cord blood pH. However, the authors did not differentiate between the sFlt-1/PlGF cutoff value for angiogenic early (> 85 at < 34 weeks) and late (> 110 at ≥ 34 weeks) onset PE, and the study population was very heterogeneous, with varying degrees of PD severity 9 .…”

Section: Reviewmentioning

confidence: 90%

“…Recent data on the use of the sFlt-1/PIGF ratio for APO prediction (including serious maternal and neonatal morbidity and fetal/neonatal mortality) in placental disease and unselected pregnancies remains controversial. Some authors found that it had a predictive value 6 , 7 , 8 , 9 , 10 , others reported that the sFlt-1/PlGF ratio only had a low to moderate use for the prediction of APO 11 , 12 , 13 , 14 . In general, a high sFlt-1/PlGF ratio is related to placental dysfunction (PD), which may be an indication of PE but also of fetal growth restriction (FGR) 15 , 16 , 17 .…”

Section: Introductionmentioning

confidence: 99%

Prediction of Adverse Pregnancy Outcome Related to Placental Dysfunction Using the sFlt-1/PlGF Ratio: A Narrative Review

Graupner

Enzensberger

2021

Geburtshilfe Frauenheilkd.

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The sFlt-1 (soluble fms-like tyrosine kinase-1)/PlGF (placental growth factor) ratio is a helpful tool for the prediction and diagnosis of preeclampsia (PE). Current data even show that the ratio has the potential to predict adverse pregnancy outcomes (APO) caused by placental pathologies. The aim of this article is to give a brief overview of recent findings on APO predictions based on the sFlt-1/PlGF ratio. The focus is on obstetric pathologies related to placental dysfunction (PD) such as PE and/or fetal growth restriction (FGR). New uses of the sFlt-1/PlGF ratio as a predictor of APO demonstrate its potential with regard to planning hospitalization and corticosteroid administration and the optimal timing of delivery. However, prospective interventional studies are warranted to define the exact role of the sFlt-1/PlGF ratio as a predictor of adverse pregnancy outcomes caused by placental pathologies.

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The sFlt-1/PlGF ratio values within the <38, 38–85 and >85 brackets as compared to perinatal outcomes

Cited by 20 publications

References 21 publications

Cerebrospinal beta-amyloid peptides(1-40) and (1-42) in severe preeclampsia and HELLP syndrome – a pilot study

Cerebrospinal beta-amyloid peptides(1-40) and (1-42) in severe preeclampsia and HELLP syndrome – a pilot study

sFlt-1/PlGF Ratio in Prediction of Short-Term Neonatal Outcome of Small for Gestational Age Neonates

Prediction of Adverse Pregnancy Outcome Related to Placental Dysfunction Using the sFlt-1/PlGF Ratio: A Narrative Review

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