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.
Perinatology Research Branch, National Institute of Child Health & Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD, USA.
Tinnakorn
T
Chaiworapongsa
Roberto
R
Romero
Jimmy
J
Espinoza
Emmanuel
E
Bujold
Yeon
Y
Mee Kim
Luis F
LF
Gonçalves
Ricardo
R
Gomez
Samuel
S
Edwin
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