An automated method for the determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia

Verlohren, Stefan; Galindo, Alberto; Schlembach, Dietmar; Zeisler, Harald; Herraı̀z, Ignacio; Moertl, Manfred Georg; Pape, Juliane; Dudenhausen, Joachim W.; Denk, B.; Stepan, Holger

doi:10.1016/j.ajog.2009.09.016

Cited by 371 publications

(366 citation statements)

References 45 publications

Supporting

Mentioning

324

Contrasting

Unclassified

Order By: Relevance

“…Using serum samples, Verlohren et al [20] found an AUC (area under curve) of 0.95 for all preeclampsia cases and 0.97 for early-onset preeclampsia. Knudsen et al [21] found that clinical sensitivity of the Triage PlGF test for the pooled GA range of 21 \ GA \ 35 using a gestational age-dependent variable cutoff is 1.0 with a corresponding clinical specificity of 0.94.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Placental Growth Factor Assay as a Novel Biomarker in Predicting Early-Onset Preeclampsia in High-Risk Patients

Mathur

Maru

et al. 2015

J Obstet Gynecol India

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Placental Growth Factor Assay as a Novel Biomarker in Predicting Early-Onset Preeclampsia in High-Risk Patients

Mathur

Maru

et al. 2015

J Obstet Gynecol India

View full text Add to dashboard Cite

“…The ratio of sFlt-1/PlGF was found to be more predictive than the single markers 6 . Since the first introduction of the 'antiangiogenic ratio' by Levine and Karumanchi 7 , it has been shown repeatedly that the ratio is superior to sFlt-1 or PlGF alone.…”

mentioning

confidence: 86%

Re: Rational and irrational ratios

Verlohren

Stepan

2017

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

“…A large number of studies, both experimental and human, have shown consistent increases in sFlt-1 in PE, and have suggested using it either alone or in combination with serum PlGF (as sFlt-1:PlGF ratio) to differentiate PE from other hypertensive disorders of pregnancy. 2,5,6 Several studies have shown that these possess superior discriminatory ability than that shown by the authors. 5,7,8 In a comparative study of pre-eclamptic and normotensive pregnancies, we found the circulating sFlt-1 to be significantly increased in PE compared with normotensive pregnancies, 9 whereas the mean PlGF levels were reduced.…”

mentioning

confidence: 89%

Angiogenic balance and diagnosis of pre-eclampsia: selecting the right VEGF receptor

et al. 2011

View full text Add to dashboard Cite

We read with interest the report by Rath and Tripathi 1 in which they have evaluated the levels of serum vascular endothelial growth factor (VEGF) and soluble VEFR receptor type 2 in hypertensive disorders of pregnancy. Their findings are certainly intriguing. First, they found increased VEGF levels in pre-eclampsia (PE) and eclampsia. This is contrary to what has been noted in almost all published reports that show reduced VEGF levels. [2][3][4][5] In our investigations, we have consistently found circulating VEGF levels to be undetectable in PE/eclampsia. The basis for this reduction is also well defined. There is ample evidence to prove that circulating VEGF as well as placental growth factor (PlGF) are bound to the excess soluble fms-like tyrosine kinase-1 (sFlt-1) or sVEGFR-1 that is produced by the preeclamptic placenta. 2 There is a close relationship between the elevated sFlt-1 and the reduction in VEGF and PlGF. The authors have not discussed this major difference between published reports and their findings. It is unclear whether the kit used in their study measured free or total (free as well as that bound to sFLt-1) VEGF. If it measures both forms of VEGF, then the total levels could be elevated. 3 This distinction is critical, however, as it is only the free VEGF that is biologically available. Interestingly, their explanation of the reduced sVEGRF2 level is based on the premise that this reflects receptor downregulation as a result of excess VEGF.Also of interest is their decision to evaluate sVEGFR2 as a diagnostic marker. The hypothesis behind the utility of this molecule as a diagnostic marker is unclear. In contrast the biological basis behind alterations in sFlt-1 in PE has been well studied. A large number of studies, both experimental and human, have shown consistent increases in sFlt-1 in PE, and have suggested using it either alone or in combination with serum PlGF (as sFlt-1:PlGF ratio) to differentiate PE from other hypertensive disorders of pregnancy. 2,5,6 Several studies have shown that these possess superior discriminatory ability than that shown by the authors. 5,7,8 In a comparative study of pre-eclamptic and normotensive pregnancies, we found the circulating sFlt-1 to be significantly increased in PE compared with normotensive pregnancies, 9 whereas the mean PlGF levels were reduced. Receiver operating characteristic curve analysis showed that sFlt-1 and sFlt-1:PlGF ratio cutoffs of 15.7 and 92.2 ng ml À1 , respectively, were able to distinguish PE from normotensive pregnancies with 100% sensitivity and specificity. PlGF alone had a slightly lower performance (cutoff 177.1 pg ml À1 ; AUC ¼ 98.3%; 95% CI 96.9-99.7).Apart from the fact that the findings are difficult to understand, some conclusions made in the paper seem to be overinterpretation of findings. These include suggestions of a 'role' for sVEGFR2 in the pathogenesis of PE, and that sVEGFR2 reflects endothelial health or endothelial progenitor cell regenerative ability. It is difficult to find the biological significance o...

show abstract

An automated method for the determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia

Cited by 371 publications

References 45 publications

A Prospective Study of Placental Growth Factor Assay as a Novel Biomarker in Predicting Early-Onset Preeclampsia in High-Risk Patients

A Prospective Study of Placental Growth Factor Assay as a Novel Biomarker in Predicting Early-Onset Preeclampsia in High-Risk Patients

Re: Rational and irrational ratios

Angiogenic balance and diagnosis of pre-eclampsia: selecting the right VEGF receptor

Contact Info

Product

Resources

About