Problem statement: To assess the plasma concentrations and placental gene expression of
soluble fms like tyrosine kinase (sFlt-1), Vascular Endothelial Growth Factor (VEGF), visfatin and
Tumour Necrosis Factor α (TNFα) in a rat model of preeclampsia, induced by chronic Reduction of
Uterine Perfusion Pressure (RUPP) and to investigate the involvement of Insulin Resistance (IR) in the
pathophysiology of preeclampsia and the possible relation of visfatin and TNFα to IR in preclampsia.
Approach: Twenty female Sprague-Dawley rats weighing 220-250 g were divided into either RUPP
(n = 10) or Normal Pregnant (NP; n = 10) (control) groups. Plasma levels and placental gene
expression of sFlt-1, VEGF, visfatin, TNFα, plasma endothelin (ET-1), glucose, serum insulin,
creatinine, HOMA-IR and placental Malondialdehyde (MDA) and total antioxidants were measured.
Also, Mean Arterial Pressure (MAP), fetal number and weight were determined. Results: In RUPP
rats, MAP increased, plasma level and placental gene expression of sFlt-1, visfatin and TNFα
increased while those of VEGF decreased. Moreover, plasma ET-1, glucose, insulin, HOMA-IR
increased while GFR, fetal weight and number decreased. There is a significant positive correlation
between TNFα, ET-1, sFlt-1 and MAP, between plasma visfatin or TNFα levels and both serum insulin
and HOMA-IR, between visfatin and TNFα, between TNFα and ET-1 and between placental MDA
and either sFlt-1 or ET-1. Furthermore, a negative correlation was reported between VEGF and MAP.
Conclusion: RUPP increased sFlt-1, TNFα and decreased VEGF resulting in endothelial dysfunction
which is manifested by increased MDA and ET-1. This results in altered renal function and
hypertension. Moreover, IR may be involved in the pathophysiology of preeclampsia. Visfatin and
TNFα, may have a role in IR during preclampsia