Associations Between Soluble fms‐Like Tyrosine Kinase‐1 and Placental Growth Factor and Disease Severity Among Women With Preterm Eclampsia and Preeclampsia
Background The angiogenic factors soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) are postulated to be pathogenic disease drivers of preeclampsia. If true, then circulating levels should become more deranged with increasing disease severity. Methods and Results We inve...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.024395 |
| _version_ | 1828151667735920640 |
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| author | Roxanne Hastie Lina Bergman Susan P. Walker Tu'uhevaha Kaitu'u‐Lino Natalie J. Hannan Fiona Brownfoot Sonja Schell Alesia Harper Ping Cannon Catherine A. Cluver Stephen Tong |
| author_facet | Roxanne Hastie Lina Bergman Susan P. Walker Tu'uhevaha Kaitu'u‐Lino Natalie J. Hannan Fiona Brownfoot Sonja Schell Alesia Harper Ping Cannon Catherine A. Cluver Stephen Tong |
| author_sort | Roxanne Hastie |
| collection | DOAJ |
| description | Background The angiogenic factors soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) are postulated to be pathogenic disease drivers of preeclampsia. If true, then circulating levels should become more deranged with increasing disease severity. Methods and Results We investigated the association between circulating sFlt‐1 and PlGF levels and severe adverse maternal outcomes among 348 women with preeclampsia. Compared with 125 women with preeclampsia without severe features, 25 women with preeclampsia and any of hemolysis, elevated liver enzymes, low platelet count syndrome, disseminated intravascular coagulation, or severe renal involvement had sFlt‐1 levels that were 2.63‐fold higher (95% CI, 1.81–3.82), sFlt‐1/PlGF levels that were 10.07‐fold higher (95% CI, 5.36–18.91) and PlGF levels that were 74% lower (adjusted fold change, 0.26 [95% CI, 0.18–0.39]). Compared with 125 women with preeclampsia without severe features, 37 with eclampsia had sFlt‐1 levels that were 2‐fold higher (2.02 [95% CI, 1.32–3.09]), sFlt‐1/PIGF levels that were 4.71‐fold higher (95% CI, 2.30–9.66) and PIGF levels that were 63% lower (0.43‐fold change [95% CI, 0.27–0.68]). Compared with those without severe features, preeclampsia with severe hypertension (n=146) was also associated with altered angiogenic levels (sFlt‐1, 1.71‐fold change [95% CI, 1.39–2.11]; sFlt/PlGF, 2.91 [95% CI, 2.04–4.15]; PlGF, 0.59 [95%CI 0.47–0.74]). We also found that sFlt‐1 and PlGF levels were altered by the number of maternal complications experienced. Conclusions Further angiogenic imbalance among women with preeclampsia is likely a pathogenic disease driver responsible for the life‐threatening maternal complications. |
| first_indexed | 2024-04-11T22:00:43Z |
| format | Article |
| id | doaj.art-ce31eed7eed84510833ab10efcf561d1 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-11T22:00:43Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-ce31eed7eed84510833ab10efcf561d12022-12-22T04:00:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-08-01111610.1161/JAHA.121.024395Associations Between Soluble fms‐Like Tyrosine Kinase‐1 and Placental Growth Factor and Disease Severity Among Women With Preterm Eclampsia and PreeclampsiaRoxanne Hastie0Lina Bergman1Susan P. Walker2Tu'uhevaha Kaitu'u‐Lino3Natalie J. Hannan4Fiona Brownfoot5Sonja Schell6Alesia Harper7Ping Cannon8Catherine A. Cluver9Stephen Tong10Mercy Perinatal Mercy Hospital for Women Melbourne AustraliaDepartment of Women’s and Children’s health Uppsala University Uppsala SwedenMercy Perinatal Mercy Hospital for Women Melbourne AustraliaMercy Perinatal Mercy Hospital for Women Melbourne AustraliaMercy Perinatal Mercy Hospital for Women Melbourne AustraliaMercy Perinatal Mercy Hospital for Women Melbourne AustraliaDepartment of Obstetrics and Gynaecology Stellenbosch University Cape Town South AfricaMercy Perinatal Mercy Hospital for Women Melbourne AustraliaMercy Perinatal Mercy Hospital for Women Melbourne AustraliaMercy Perinatal Mercy Hospital for Women Melbourne AustraliaMercy Perinatal Mercy Hospital for Women Melbourne AustraliaBackground The angiogenic factors soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) are postulated to be pathogenic disease drivers of preeclampsia. If true, then circulating levels should become more deranged with increasing disease severity. Methods and Results We investigated the association between circulating sFlt‐1 and PlGF levels and severe adverse maternal outcomes among 348 women with preeclampsia. Compared with 125 women with preeclampsia without severe features, 25 women with preeclampsia and any of hemolysis, elevated liver enzymes, low platelet count syndrome, disseminated intravascular coagulation, or severe renal involvement had sFlt‐1 levels that were 2.63‐fold higher (95% CI, 1.81–3.82), sFlt‐1/PlGF levels that were 10.07‐fold higher (95% CI, 5.36–18.91) and PlGF levels that were 74% lower (adjusted fold change, 0.26 [95% CI, 0.18–0.39]). Compared with 125 women with preeclampsia without severe features, 37 with eclampsia had sFlt‐1 levels that were 2‐fold higher (2.02 [95% CI, 1.32–3.09]), sFlt‐1/PIGF levels that were 4.71‐fold higher (95% CI, 2.30–9.66) and PIGF levels that were 63% lower (0.43‐fold change [95% CI, 0.27–0.68]). Compared with those without severe features, preeclampsia with severe hypertension (n=146) was also associated with altered angiogenic levels (sFlt‐1, 1.71‐fold change [95% CI, 1.39–2.11]; sFlt/PlGF, 2.91 [95% CI, 2.04–4.15]; PlGF, 0.59 [95%CI 0.47–0.74]). We also found that sFlt‐1 and PlGF levels were altered by the number of maternal complications experienced. Conclusions Further angiogenic imbalance among women with preeclampsia is likely a pathogenic disease driver responsible for the life‐threatening maternal complications.https://www.ahajournals.org/doi/10.1161/JAHA.121.024395antiangiogenic factorseclampsiaPlGFpreeclampsiasevere featuressFlt‐1 |
| spellingShingle | Roxanne Hastie Lina Bergman Susan P. Walker Tu'uhevaha Kaitu'u‐Lino Natalie J. Hannan Fiona Brownfoot Sonja Schell Alesia Harper Ping Cannon Catherine A. Cluver Stephen Tong Associations Between Soluble fms‐Like Tyrosine Kinase‐1 and Placental Growth Factor and Disease Severity Among Women With Preterm Eclampsia and Preeclampsia Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease antiangiogenic factors eclampsia PlGF preeclampsia severe features sFlt‐1 |
| title | Associations Between Soluble fms‐Like Tyrosine Kinase‐1 and Placental Growth Factor and Disease Severity Among Women With Preterm Eclampsia and Preeclampsia |
| title_full | Associations Between Soluble fms‐Like Tyrosine Kinase‐1 and Placental Growth Factor and Disease Severity Among Women With Preterm Eclampsia and Preeclampsia |
| title_fullStr | Associations Between Soluble fms‐Like Tyrosine Kinase‐1 and Placental Growth Factor and Disease Severity Among Women With Preterm Eclampsia and Preeclampsia |
| title_full_unstemmed | Associations Between Soluble fms‐Like Tyrosine Kinase‐1 and Placental Growth Factor and Disease Severity Among Women With Preterm Eclampsia and Preeclampsia |
| title_short | Associations Between Soluble fms‐Like Tyrosine Kinase‐1 and Placental Growth Factor and Disease Severity Among Women With Preterm Eclampsia and Preeclampsia |
| title_sort | associations between soluble fms like tyrosine kinase 1 and placental growth factor and disease severity among women with preterm eclampsia and preeclampsia |
| topic | antiangiogenic factors eclampsia PlGF preeclampsia severe features sFlt‐1 |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.024395 |
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