TY - JOUR
T1 - Sequential changes in antiangiogenic factors in early pregnancy and risk of developing preeclampsia
AU - Rana, Sarosh
AU - Karumanchi, S. Ananth
AU - Levine, Richard J.
AU - Venkatesha, Shivalingappa
AU - Rauh-Hain, Jose Alejandro
AU - Tamez, Hector
AU - Thadhani, Ravi
PY - 2007/7/1
Y1 - 2007/7/1
N2 - Concentrations of soluble fms-like tyrosine kinase 1 (sFlt1) and soluble endoglin (sEng) increase in maternal blood with the approach of clinical preeclampsia. Although alterations in these circulating antiangiogenic factors herald the signs and symptoms of preeclampsia, in vitro studies suggest they may also play a role in regulating early placental cytotrophoblast functions. Early pregnancy changes in sFlt1 and sEng may thus identify women destined to develop preeclampsia. We performed a nested case-control study of 39 women who developed preeclampsia and 147 contemporaneous normotensive controls each with serum collected in the first (11 to 13 weeks of gestation) and second (17 to 20 weeks) trimesters. Whereas levels of sFlt1 and sEng at 11 to 13 weeks were similar between cases and controls (sFlt1: 3.5±0.3 ng/mL versus 3.0±0.1, P=0.14; sEng 6.9±0.3 ng/mL versus 6.6±0.2, P=0.37, respectively), at 17 to 20 weeks both were elevated in the women destined to develop preeclampsia (sFlt1: 4.1±0.5 ng/mL versus 3.1±0.1, P<0.05; sEng, 6.4±0.4 ng/mL versus 5.2±0.1, P<0.01). Women who developed preterm (<37 weeks) preeclampsia demonstrated even greater sequential changes: difference [delta{d}] between second and first trimester levels: dsFlt1, 0.63±0.91 ng/mL in preterm PE versus 0.05±0.15 in controls; dsEng, 0.73±0.77 ng/mL versus -1.32±0.18, P<0.01. Similar findings were noted in a cross-sectional analysis of specimens collected from the Calcium for Preeclampsia Prevention Study. In conclusion, sequential changes in antiangiogenic factors during early pregnancy may be useful for predicting preterm preeclampsia.
AB - Concentrations of soluble fms-like tyrosine kinase 1 (sFlt1) and soluble endoglin (sEng) increase in maternal blood with the approach of clinical preeclampsia. Although alterations in these circulating antiangiogenic factors herald the signs and symptoms of preeclampsia, in vitro studies suggest they may also play a role in regulating early placental cytotrophoblast functions. Early pregnancy changes in sFlt1 and sEng may thus identify women destined to develop preeclampsia. We performed a nested case-control study of 39 women who developed preeclampsia and 147 contemporaneous normotensive controls each with serum collected in the first (11 to 13 weeks of gestation) and second (17 to 20 weeks) trimesters. Whereas levels of sFlt1 and sEng at 11 to 13 weeks were similar between cases and controls (sFlt1: 3.5±0.3 ng/mL versus 3.0±0.1, P=0.14; sEng 6.9±0.3 ng/mL versus 6.6±0.2, P=0.37, respectively), at 17 to 20 weeks both were elevated in the women destined to develop preeclampsia (sFlt1: 4.1±0.5 ng/mL versus 3.1±0.1, P<0.05; sEng, 6.4±0.4 ng/mL versus 5.2±0.1, P<0.01). Women who developed preterm (<37 weeks) preeclampsia demonstrated even greater sequential changes: difference [delta{d}] between second and first trimester levels: dsFlt1, 0.63±0.91 ng/mL in preterm PE versus 0.05±0.15 in controls; dsEng, 0.73±0.77 ng/mL versus -1.32±0.18, P<0.01. Similar findings were noted in a cross-sectional analysis of specimens collected from the Calcium for Preeclampsia Prevention Study. In conclusion, sequential changes in antiangiogenic factors during early pregnancy may be useful for predicting preterm preeclampsia.
KW - Antiangiogenic factors
KW - Predictive test
KW - Preeclampsia
KW - sFlt1
KW - Soluble endoglin
UR - http://www.scopus.com/inward/record.url?scp=34250858133&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34250858133&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.107.087700
DO - 10.1161/HYPERTENSIONAHA.107.087700
M3 - Article
C2 - 17515455
AN - SCOPUS:34250858133
SN - 0194-911X
VL - 50
SP - 137
EP - 142
JO - Hypertension
JF - Hypertension
IS - 1
ER -