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Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders

Preeclampsia is a devastating medical complication of pregnancy that can lead to significant maternal and fetal morbidity and mortality. It is currently believed that there is abnormal placentation in as early as the first trimester in women destined to develop preeclampsia. Although the etiology of...

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Autores principales: Rana, Sarosh, Burke, Suzanne D., Karumanchi, S. Ananth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884164/
https://www.ncbi.nlm.nih.gov/pubmed/33096092
http://dx.doi.org/10.1016/j.ajog.2020.10.022
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author Rana, Sarosh
Burke, Suzanne D.
Karumanchi, S. Ananth
author_facet Rana, Sarosh
Burke, Suzanne D.
Karumanchi, S. Ananth
author_sort Rana, Sarosh
collection PubMed
description Preeclampsia is a devastating medical complication of pregnancy that can lead to significant maternal and fetal morbidity and mortality. It is currently believed that there is abnormal placentation in as early as the first trimester in women destined to develop preeclampsia. Although the etiology of the abnormal placentation is being debated, numerous epidemiologic and experimental studies suggest that imbalances in circulating angiogenic factors released from the placenta are responsible for the maternal signs and symptoms of preeclampsia. In particular, circulating levels of soluble fms-like tyrosine kinase 1, an antiangiogenic factor, are markedly increased in women with preeclampsia, whereas free levels of its ligand, placental, growth factor are markedly diminished. Alterations in these angiogenic factors precede the onset of clinical signs of preeclampsia and correlate with disease severity. Recently, the availability of automated assays for the measurement of angiogenic biomarkers in the plasma, serum, and urine has helped investigators worldwide to demonstrate a key role for these factors in the clinical diagnosis and prediction of preeclampsia. Numerous studies have reported that circulating angiogenic biomarkers have a very high negative predictive value to rule out clinical disease among women with suspected preeclampsia. These blood-based biomarkers have provided a valuable tool to clinicians to accelerate the time to clinical diagnosis and minimize maternal adverse outcomes in women with preeclampsia. Angiogenic biomarkers have also been useful to elucidate the pathogenesis of related disorders of abnormal placentation such as intrauterine growth restriction, intrauterine fetal death, twin-to-twin transfusion syndrome, and fetal hydrops. In summary, the discovery and characterization of angiogenic proteins of placental origin have provided clinicians a noninvasive blood-based tool to monitor placental function and health and for early detection of disorders of placentation. Uncovering the mechanisms of altered angiogenic factors in preeclampsia and related disorders of placentation may provide insights into novel preventive and therapeutic options.
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spelling pubmed-88841642022-03-02 Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders Rana, Sarosh Burke, Suzanne D. Karumanchi, S. Ananth Am J Obstet Gynecol Expert Review Preeclampsia is a devastating medical complication of pregnancy that can lead to significant maternal and fetal morbidity and mortality. It is currently believed that there is abnormal placentation in as early as the first trimester in women destined to develop preeclampsia. Although the etiology of the abnormal placentation is being debated, numerous epidemiologic and experimental studies suggest that imbalances in circulating angiogenic factors released from the placenta are responsible for the maternal signs and symptoms of preeclampsia. In particular, circulating levels of soluble fms-like tyrosine kinase 1, an antiangiogenic factor, are markedly increased in women with preeclampsia, whereas free levels of its ligand, placental, growth factor are markedly diminished. Alterations in these angiogenic factors precede the onset of clinical signs of preeclampsia and correlate with disease severity. Recently, the availability of automated assays for the measurement of angiogenic biomarkers in the plasma, serum, and urine has helped investigators worldwide to demonstrate a key role for these factors in the clinical diagnosis and prediction of preeclampsia. Numerous studies have reported that circulating angiogenic biomarkers have a very high negative predictive value to rule out clinical disease among women with suspected preeclampsia. These blood-based biomarkers have provided a valuable tool to clinicians to accelerate the time to clinical diagnosis and minimize maternal adverse outcomes in women with preeclampsia. Angiogenic biomarkers have also been useful to elucidate the pathogenesis of related disorders of abnormal placentation such as intrauterine growth restriction, intrauterine fetal death, twin-to-twin transfusion syndrome, and fetal hydrops. In summary, the discovery and characterization of angiogenic proteins of placental origin have provided clinicians a noninvasive blood-based tool to monitor placental function and health and for early detection of disorders of placentation. Uncovering the mechanisms of altered angiogenic factors in preeclampsia and related disorders of placentation may provide insights into novel preventive and therapeutic options. Elsevier 2022-02 /pmc/articles/PMC8884164/ /pubmed/33096092 http://dx.doi.org/10.1016/j.ajog.2020.10.022 Text en © 2020 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Expert Review
Rana, Sarosh
Burke, Suzanne D.
Karumanchi, S. Ananth
Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders
title Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders
title_full Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders
title_fullStr Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders
title_full_unstemmed Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders
title_short Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders
title_sort imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders
topic Expert Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884164/
https://www.ncbi.nlm.nih.gov/pubmed/33096092
http://dx.doi.org/10.1016/j.ajog.2020.10.022
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