title: Angiogenic balance (sFlt-1/PlGF) and preeclampsia.
abstract: Preeclampsia is a hypertensive disorder of pregnancy associated with important maternal and perinatal mortality and morbidity. Although symptomatic management has improved, there is currently no curative treatment, and only childbirth and delivery of the placenta, usually prematurely, alleviate the mother's symptoms. Placental insufficiency plays a central role in the pathophysiology of preeclampsia. Abnormal placentation during the first trimester leads to defective remodeling of the uterine vascularization. This results progressively in placental hypoperfusion, which induces trophoblast dysfunction and the release in maternal circulation of trophoblastic factors leading to an excessive inflammatory response, endothelial dysfunction and glomerular damage. Among these factors, the most important is sFlt-1, which is a soluble form of the VEGF and PlGF receptor. sFlt-1 binds to free VEGF and PlGF in the maternal circulation, thus reducing their bioavailability for their membrane receptor. The result is inhibition of the effects of VEGF and PlGF on maternal endothelial cells and podocytes. The sFlt-1/PlGF ratio reflects the circulating angiogenic balance and is correlated with severity of the disease.
authors.affiliation: Inserm, UMR-S 1139, 75014 Paris, France; PRES Sorbonne Paris Cité, université Paris Descartes, 75014 Paris, France; Port-Royal maternity, department of gynecology obstetrics I, centre hospitalier universitaire Cochin, Broca Hôtel-Dieu, groupe hospitalier universitaire Ouest, Assistance publique-Hôpital de Paris, 75014 Paris, France; DHU risques et grossesse, 75014 Paris, France; PremUP Foundation, 75014 Paris, France.
authors.forename: Edouard
authors.initials: E
authors.lastname: Lecarpentier
authors.affiliation: Inserm, UMR-S 1139, 75014 Paris, France; PRES Sorbonne Paris Cité, université Paris Descartes, 75014 Paris, France; Port-Royal maternity, department of gynecology obstetrics I, centre hospitalier universitaire Cochin, Broca Hôtel-Dieu, groupe hospitalier universitaire Ouest, Assistance publique-Hôpital de Paris, 75014 Paris, France; DHU risques et grossesse, 75014 Paris, France; PremUP Foundation, 75014 Paris, France. Electronic address: vassilis.tsatsaris@cch.aphp.fr.
authors.forename: Vassilis
authors.initials: V
authors.lastname: Tsatsaris
mesh_terms: D005260:Female; D017048:Health Care Costs; D006801:Humans; D018919:Neovascularization, Physiologic / Q000235:genetics / Q000502:physiology*; D000072483:Placenta Growth Factor / Q000502:physiology*; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000502:physiology*
chemical_list: C000608036:PGF protein, human; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: PlGF; Placenta; Preelampsia; Préélampsie; SFlt-1