An automated method for the determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia.
OBJECTIVE
The angiogenic and antiangiogenic factors soluble fms-like tyrosine kinase (sFlt)-1 and placental growth factor (PIGF) have been implicated in the mechanisms of disease responsible for preeclampsia (PE). Moreover, it has been proposed that the concentrations of these markers in maternal serum/plasma may have predictive value. This study evaluates a newly developed Elecsys (Roche, Penzberg, Germany) assay for sFlt-1 and PIGF and tests the value of the sFlt-1/PIGF ratio in the assessment of PE.


METHODS
This multicenter case-control study included 351 patients: 71 patients with PE and 280 gestational age-matched control subjects from 5 European study centers. A total of 595 serum samples were measured for sFlt-1 and PIGF using an automated platform.


RESULTS
Maternal serum concentrations of sFlt-1 and PIGF significantly separated healthy women and women with PE. The sFlt-1/PIGF ratio had an area under the receiver operating characteristic curve of 0.95. The best performance was obtained in the identification of early-onset PE (area under the receiver operating characteristic curve of 0.97).


CONCLUSIONS
Measurement of sFlt-1 and PIGF and calculation of sFlt-1/PIGF ratio can be performed quickly and in a platform available in clinical laboratories. This is a substantial step forward in bringing the determination of these analytes to clinical practice in obstetrics. We propose that sFlt-1, PIGF, and sFlt-1/PIGF ratio may be of value in the prediction of PE and in the differential diagnosis of patients with atypical presentations of PE, and perhaps in the differential diagnosis of women with chronic hypertension suspected to develop superimposed PE.
Department of Obstetrics, Campus Virchow-Clinic, Charité University Medicine, Berlin, Germany.
Stefan
S
Verlohren
Alberto
A
Galindo
Dietmar
D
Schlembach
Harald
H
Zeisler
Ignacio
I
Herraiz
Manfred G
MG
Moertl
Juliane
J
Pape
Joachim W
JW
Dudenhausen
Barbara
B
Denk
Holger
H
Stepan
D000328:Adult; D043925:Angiogenesis Inducing Agents / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D008565:Membrane Proteins / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis*; D011247:Pregnancy; D012372:ROC Curve; D012016:Reference Values; D012680:Sensitivity and Specificity; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
D043925:Angiogenesis Inducing Agents; D008565:Membrane Proteins; C098069:PIGF protein, human; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1