Evidence supporting a role for blockade of the vascular endothelial growth factor system in the pathophysiology of preeclampsia. Young Investigator Award.
OBJECTIVE
Soluble vascular endothelial growth factor receptor 1 (sVEGFR-1), which antagonizes VEGF functions, has been implicated in the pathophysiology of preeclampsia. The purpose of this study was to determine whether preeclampsia is associated with a change in the plasma concentration of sVEGFR-1, and, if so, whether such a change is correlated with the severity of the disease.


METHODS
A cross-sectional study was conducted to determine the concentrations of sVEGFR-1 in plasma obtained from normal pregnant women (n=61) and patients with preeclampsia (n=61). Plasma concentrations of sVEGFR-1 were determined by enzyme-linked immunoassay.


RESULTS
Preeclampsia had a higher median plasma concentration of sVEGFR-1 than normal pregnancy (P <.001). The median plasma concentration of sVEGFR-1 was higher in early-onset (< or =34 weeks) than late-onset (>34 weeks) preeclampsia (P=.005), and higher in severe than in mild preeclampsia (P=.002). In normal pregnancy, there was a correlation between plasma concentration of sVEGFR-1 and gestational age (r=0.5; P <.001). In contrast, there was a negative correlation between plasma concentration of sVEGFR-1 and gestational age at the onset of preeclampsia (r=-0.5; P <.001).


CONCLUSIONS
Preeclampsia is associated with an increased plasma sVEGFR-1 concentration. The elevation of sVEGFR-1 concentration is correlated with the severity of the disease. These observations suggest the participation of VEGF and its soluble receptor in the pathophysiology of preeclampsia.
Chaiworapongsa
Tinnakorn
T
Perinatology Research Branch, National Institute of Child Health & Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, USA.
Romero
Roberto
R
Espinoza
Jimmy
J
Bujold
Emmanuel
E
Mee Kim
Yeon
Y
Gonçalves
Luis F
LF
Gomez
Ricardo
R
Edwin
Samuel
S
D000293:Adolescent; D000328:Adult; D001363:Awards and Prizes; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D008423:Maternal Age; D011225:Pre-Eclampsia / Q000097:blood* / Q000517:prevention & control; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
D015415:Biomarkers; D040281:Vascular Endothelial Growth Factor Receptor-1