Angiogenic and Antiangiogenic Factors in the Genesis of Placental Abnormalities

Abstract

Aim. To evaluate the role of placenta growth factor (PlGF), vascular endothelial growth factor (VEGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in the pathogenesis of placental adherent and invasive pathology (PAIP). Key points. sFlt-1 is an inhibitor of the angiogenic action of PLGF and VEGF. The concentration of sFlt-1 in the blood serum of patients with PAIP was significantly lower than in women with physiological pregnancy in all the studies presented in this review. Only two studies have determined thresholds for serum markers for PAIP, but according to the results of the meta-analysis, they had large differences. Despite the known proangiogenic function of VEGF and PlGF, a significant correlation between their levels was not found either in serum by enzyme immunoassay or in expression on chorionic cells, decidual tissue and myometrium in abnormal placental invasion. Conclusion. Further study of the role of VEFG, PlGF and sFlt-1 in the pathogenesis of PAIP is needed to find their threshold levels in the blood and use as a diagnostic markers. Keywords: placental adherent and invasive pathology, placenta previa, vascular endothelial growth factor, placenta growth factor, soluble fms-like tyrosine kinase-1, vascular endothelial growth factor receptors-l and -2.