Urinary angiogenic factors cluster hypertensive disorders and identify women with severe preeclampsia

Buhimschi, Catalin S.; Norwitz, Errol R.; Richman, Susan; Funai, Edmund F.; Guller, Seth; Lockwood, Charles; Buhimschi, Irina A.

doi:10.1016/j.ajog.2004.09.067

Cited by 18 publications

(33 citation statements)

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“…According to the manufacturer, mean minimal detectable doses are: 9 pg/ml for VEGF, 7 pg/ml for PlGF, 5.01 pg/ ml for sFlt-1, 4.6 pg/ml for sKDR and 0.22 pg/ml for bFGF. The ratio of sFlt-1/PlGF was computed using the formula [log (sFlt-1/PlGF × 10)] described by Buhimschi et al [18].…”

Section: Methodsmentioning

confidence: 99%

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Angiogenic growth factors in maternal and fetal serum in pregnancies complicated by intrauterine growth restriction

et al. 2006

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The present study was performed to compare serum concentrations of maternal and fetal angiogenic growth factors in IUGR (intrauterine growth restriction) and normal pregnancy at the time of delivery. VEGF (vascular endothelial growth factor), PlGF (placental growth factor), sFlt-1 (soluble fms-like tyrosine kinase 1), sKDR (soluble kinase domain receptor) and bFGF (basic fibroblast growth factor) were measured by ELISA in serum from a maternal peripheral vein, the umbilical vein and the umbilical arteries in 15 women with pregnancies complicated by IUGR and 16 controls (women with normal pregnancies). In IUGR, sFlt-1 was increased, and PlGF and sKDR were decreased, in both maternal serum and serum from the umbilical vein. Additionally, bFGF was increased in serum from the umbilical vein of women with pregnancies complicated by IUGR. No significant differences in growth factor concentrations between the groups were found in serum from the umbilical artery. In both groups, levels of VEGF were higher and levels of sFlt-1 were lower in serum from the umbilical vein and umbilical artery compared with maternal serum. PlGF levels were found to be lower in serum from the umbilical vein compared with maternal serum in both groups, whereas PlGF levels in serum from the umbilical artery were significantly lower only in the control group. These findings suggest an imbalance of angiogenic and anti-angiogenic factors in IUGR, with formation of an anti-angiogenic state in maternal and, to a lesser extent, umbilical vein blood. The placenta appears to play a central role in the release of sFlt-1 into maternal and umbilical blood. Umbilical artery blood was unaffected in IUGR, indicating that the fetus does not contribute to changes in angiogenic growth factor concentrations.

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Section: Methodsmentioning

confidence: 99%

“…The ratio of sFlt-1/PlGF was computed using the formula described by Buhimschi et al [18]. Horizontal lines indicate the mean values.…”

Section: Figure 1 Ratio Of Sflt-1 and Free Plgf In Control And Iugr Gmentioning

confidence: 99%

Angiogenic growth factors in maternal and fetal serum in pregnancies complicated by intrauterine growth restriction

et al. 2006

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“…The use of these markers as an aid in prediction and an aid in diagnosis of pre-eclampsia was especially useful when a ratio was calculated. Raised sFlt-1/PlGF ratios indicated women with pre-eclampsia in earlier studies and some reports evaluated the use of a urinary sFlt-1/PlGF ratio [94]. Levine et al [12] were the first to provide evidence that the sFlt-1/PlGF ratio is able to predict the later onset of the disease in women at risk for developing pre-eclampsia [12].…”

Section: Prediction Of Pre-eclampsiamentioning

confidence: 96%

Angiogenic growth factors in the diagnosis and prediction of pre-eclampsia

2011

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The pathogenesis of pre-eclampsia is still not completely known; however, in the recent decade, there have been tremendous research efforts leading to impressive results highlighting the role of a disturbed angiogenic balance as one of the key features of the disease. Numerous studies have shown the key role of the placenta in the pathogenesis of pre-eclampsia. A shift in the sFlt-1 (soluble Fms-like tyrosine kinase-1)/PlGF (placental growth factor) ratio is associated with the disease. Although pre-eclampsia seems to be a clearly defined disease, clinical presentation, and particularly the dynamics of the clinical course, can vary enormously. The only available tools to diagnose pre-eclampsia are blood pressure measurement and urine protein sampling. However, these tools have a low sensitivity and specificity regarding the prediction of the course of the disease or maternal and perinatal outcomes. The only cure for the disease is delivery, although a timely diagnosis helps in decreasing maternal and fetal morbidity and mortality. The sFlt1/PlGF ratio is able to give additional valuable information on the status and progression of the disease and is apt to be implemented in the diagnostic algorithm of pre-eclampsia. In the present review, we aim to provide an overview of the vast literature on angiogenesis and anti-angiogenesis factors in pre-eclampsia that have been published over the last decade. We introduce work from basic research groups who have focused on the pathophysiological basis of the disease. Furthermore, we review studies with a clinical focus in which the sFlt-1/PlGF ratio has been analysed along with other candidates for routine clinical assessment of pre-eclampsia.

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“…Although the cause of this pregnancy-specific syndrome is unclear, accumulating evidence suggests that preeclampsia results from an imbalance between placental pro-angiogenic and antiangiogenic factors which damage maternal vascular endothelium, leading to the clinical manifestations of this condition [5][6][7][8][9]. Due to its high prevalence and seriousness, measurements of several pro-angiogenic and antiangiogenic factors in both serum and plasma have been tested as diagnostic markers for preeclampsia as well as to assess its potential for predicting the development of this condition [6,[10][11][12][13].…”

mentioning

confidence: 99%

Changes in circulating concentrations of soluble fms-like tyrosine kinase-1 and placental growth factor measured by automated electrochemiluminescence immunoassays methods are predictors of preeclampsia

Leaños‐Miranda

Campos-Galicia

Isordia‐Salas

et al. 2012

Journal of Hypertension

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Urinary angiogenic factors cluster hypertensive disorders and identify women with severe preeclampsia

Cited by 18 publications

References 0 publications

Angiogenic growth factors in maternal and fetal serum in pregnancies complicated by intrauterine growth restriction

Angiogenic growth factors in maternal and fetal serum in pregnancies complicated by intrauterine growth restriction

Angiogenic growth factors in the diagnosis and prediction of pre-eclampsia

Changes in circulating concentrations of soluble fms-like tyrosine kinase-1 and placental growth factor measured by automated electrochemiluminescence immunoassays methods are predictors of preeclampsia

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