title: The promise of angiogenic markers for the early diagnosis and prediction of preeclampsia.
abstract: BACKGROUND
  An imbalance in circulating factors that regulate blood vessel formation and health, referred to as angiogenic factors, plays a central role in the pathogenesis of preeclampsia.
  
  
  BACKGROUND
  Several studies have demonstrated a strong association between altered circulating angiogenic factors and preeclampsia. These factors include circulating antiangiogenic proteins such as soluble fms-like tyrosine kinase 1 and soluble endoglin and proangiogenic protein such as placental growth factor. Abnormalities in these circulating angiogenic factors are not only present during clinical disease, but also antedate clinical signs and symptoms by several weeks. These alterations are particularly prominent in patients who present with preeclamptic signs and symptoms prematurely and/or in patients with severe preeclampsia. The availability of automated platforms for the rapid measurement of circulating angiogenic proteins in blood samples has now allowed researchers and clinicians to evaluate the utility of these assays in the diagnosis of the disease, in the stratification of patients in clinical trials, or in the monitoring of therapies. In this review we highlight the various studies that have been performed, with a focus on large validation studies.
  
  
  CONCLUSIONS
  Measurement of circulating angiogenic proteins for the diagnosis and prediction of preeclampsia is still at an early stage but is rapidly evolving. Standardization across the various automated platforms and prospective studies that demonstrate clinical utility are needed.
authors.affiliation: Renal Division, Department of Medicine and Centre for Molecular Medicine, University of Cologne, Cologne, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Hagmann
authors.forename: Ravi
authors.initials: R
authors.lastname: Thadhani
authors.forename: Thomas
authors.initials: T
authors.lastname: Benzing
authors.forename: S Ananth
authors.initials: SA
authors.lastname: Karumanchi
authors.forename: Holger
authors.initials: H
authors.lastname: Stepan
mesh_terms: D015703:Antigens, CD / Q000032:analysis*; D015415:Biomarkers / Q000097:blood; D042241:Early Diagnosis; D000071063:Endoglin; D005260:Female; D006801:Humans; D000072483:Placenta Growth Factor; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000032:analysis*; D011956:Receptors, Cell Surface / Q000032:analysis*; D054928:Validation Studies as Topic; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000032:analysis*
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; C064206:ENG protein, human; D000071063:Endoglin; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D011956:Receptors, Cell Surface; D000072483:Placenta Growth Factor; D040281:Vascular Endothelial Growth Factor Receptor-1