title: OS061. Placental growth factor reduces blood pressure and proteinuria in experimental preeclampsia.
abstract: BACKGROUND
  Preeclampsia is a disorder related to an imbalance in the angiogenesis axis manifesting as endothelial dysfunction. Animal and human studies have shown that sFLT-1 (soluble fms like tyrosine kinase 1) is increased and PlGF (placental growth factor) reduced during the disease state. There are a paucity of studies investigating the clinical significance of normalising angiogenic axis.
  
  
  OBJECTIVE
  To use a non-human primate uteroplacental ischemic (UPI) model of preeclampsia to assess if reversing the angiogenic imbalance, by increasing circulating PlGF, is able to ameliorate the hypertension and proteinuria.
  
  
  METHODS
  Hypertensive proteinuria was induced in a non-human primate (Papio hamadryas) by ligation of a unilateral uterine artery at 130days of an 182day pregnancy. After two weeks of UPI, PlGF was administered by subcutaneous injection (100mg/kg/day) for 5 days (n=3) or normal saline in an equivalent volume (n=3). Blood pressure was monitored via intra-arterial radiotelemetry, sFLT-1 measured via ELISA and spot urinary protein:creatinine ratios were measured to monitor proteinuria. Data was analysed using SPSS by t-tests and analysis of repeated measures. Significance was set at p<0.05 and data expressed as the mean ±SEM.
  
  
  RESULTS
  After two weeks of UPI both groups demonstrated a significant elevation in blood pressure, proteinuria (p<0.05) and sFLT-1 (p<0.001). The systolic BP increased by 12.4±2.3mmHg and 11.7±2.9mmHg in the PlGF and control groups respectively compared to baseline (p<0.005). After PlGF administration, there was a significant reduction in blood pressure in the treated group (-5.2s±0.8mmHg) compared to the increase in BP in the control group (+6.5±3mmHg). Proteinuria also reduced in the treated group from 112±51mg/mmol to 38±12mg/mmol whilst proteinuria in the control group was unchanged. The total circulating sFLT-1 was not significantly affected by the administration of PlGF after 5days. Although this study was not designed to assess fetal safety or outcomes, there was no adverse fetal outcome attributable to the administration of the PlGF.
  
  
  CONCLUSIONS
  Administration of PlGF resulted in a reduction in BP and proteinuria without significantly affecting total sFLT-1 levels. Correcting the angiogenic axis imbalance may improve the clinical parameters in a non-human primate animal model of preeclampsia.
authors.affiliation: Renal, Liverpool Hospital, Liverpool, Australia; The Heart Research Institute, Newtown, Australia; School Of Medicine, University Of Western Sydney, Campbelltown, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Makris
authors.affiliation: The Heart Research Institute, Newtown, Australia; School Of Medicine, University Of Western Sydney, Campbelltown, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Yeung
authors.affiliation: Royal Prince Alfred Hospital, Camperdown, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Farrell
authors.affiliation: Royal Prince Alfred Hospital, Camperdown, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Heffernan
authors.affiliation: Royal Prince Alfred Hospital, Camperdown, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Thompson
authors.affiliation: The Heart Research Institute, Newtown, Australia; School Of Medicine, University Of Western Sydney, Campbelltown, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Xu
authors.affiliation: Royal Prince Alfred Hospital, Camperdown, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Woolcock
authors.affiliation: Royal Prince Alfred Hospital, Camperdown, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Ogle
authors.affiliation: Massachusetts General Hospital, Boston, United States.
authors.forename: R
authors.initials: R
authors.lastname: Thadhani
authors.affiliation: Beth Israel Deaconess Medical Centre, Boston, United States.
authors.forename: A
authors.initials: A
authors.lastname: Karumanchi
authors.affiliation: The Heart Research Institute, Newtown, Australia; School Of Medicine, University Of Western Sydney, Campbelltown, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Hennessy