Expression of PIGF and sFLT-1 Biomarkers in Pregnancy Toxaemia

Abstract

Toxaemia is a pathological condition specific to the period of pregnancy which begins and is indissolubly related to the presence of placenta. Antiangiogenic factors, such as sFLT-1 (soluble tyrosine kinase receptor fms-like) and sEng (soluble endoglin) play an important role in the first part of pregnancy. They are linked to physiological vascular neoformation, and, in the second part of the pregnancy, grant the endothelial functionality and physiological vascular remodeling. The aim of the study is to try to establish the levels of the sFLT-1/PIGF ratio, as a prognostic tool in the patient with pre-eclampsia, depending on the influence of the cumulative risk factors. The sFLT-1 / PIGF report is a potential prognostic parameter in monitoring preeclampsia. The results of our study confirm the importance of deterring these markers for the diagnosis and monitoring of hypertensive pregnancies and at the same time to emphasize that the sFLT-1/PIGF ratio is a good predictor of preeclampsia Keywords: pregnancy, antiangiogenic factors, toxaemiaToxaemia is a pathological condition specific to the period of pregnancy which begins and is indissolubly related to the presence of placenta. The diseases is a multisystemic disorder, implying an increased incidence of morbidity and mortality for both the mother and the foetus[1].This condition starts even in the absence of the foetus (as is the case of the mola hydatiforme) and the symptoms usually dissapear at the time of delivery of the placenta. Toxaemia is a condition that begins at the placenta and ends in the maternal endothelium, being characterized by generalized endothelial dysfunction and affecting all susceptible vascular vessels from kidneys, central nervous system, liver to placenta [2][3][4].Antiangiogenic factors, such as sFLT-1 (soluble tyrosine kinase receptor fms-like) and sEng (soluble endoglin) play an important role in the first part of pregnancy. They are linked to physiological vascular neoformation, and, in the second part of the pregnancy, grant the endothelial functionality and physiological vascular remodeling. Soluble FLT-1 is a circulating anti-angiogenic protein that binds to the receptor of the PIGF and VEGF, thus preventing interaction with endothelial receptors, causing endothelial dysfunction. Endoglin is a surface co-receptor protein of TGF (transformig growth factor) β1 and β3 [5].The sEng factor is its soluble form, a novel anti-angiogenic factor that acts in synergy with sFLT-1. In normal pregnancy, a proangiogenic status appears, with low levels of sFLT-1 and increased levels of PIGF, by the end of the second trimester. Towards the end of the pregnancy these levels return to normal. In pregnant women with toxaemia, angiogenic profile abnormalities appear, with early changes in the prevalence of anti-angiogenic status leading to endothelial dysfunction. Thus PIGF and VEGF levels are lower than normal, and sFLT-1 and sEng levels are increased. sFLT-1 released from the placental circulation in large quantities will destroy the homeostasis of t...