Hirokoshi Kumiko, Maeshima Yohei, Kobayashi Kazuko, Matsuura Eiji, Sugiyama Hitoshi, Yamasaki Yasushi, Masuyama Hisashi, Hiramatsu Yuji, Makino Hirofumi
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Nephron Clin Pract. 2007;106(1):c43-50. doi: 10.1159/000101483. Epub 2007 Apr 2.
An imbalance of angiogenesis-associated factors may predispose to preeclampsia. Here, we determined the ratio of serum concentration of soluble fms-like tyrosine kinase 1 (sFlt-1), a natural inhibitor of pro-angiogenic vascular endothelial growth factor (VEGF) relative to angiopoietin-2 (Ang-2), a natural antagonist of angiopoietin-1 (Ang-1) involved in promoting angiogenesis in the presence of VEGF, in women with preeclampsia.
The levels of serum sFlt-1 and Ang-2 were measured by enzyme-linked immunosorbent assay.
Significant decrease of serum Ang-2 and the increase of sFlt-1 were observed in women with preeclampsia as compared to healthy pregnant women. The serum sFlt-1/Ang-2 ratio was strikingly increased in preeclamptic women in contrast to healthy pregnant women exhibiting lower value similar to non-pregnant women. The serum sFlt-1 concentrations tended to positively correlate with mean blood pressure (BP) in preeclamptic women, but not in healthy pregnant women. A cut-off value >0.25 in the serum sFlt-1/Ang-2 ratio showed 87.1% sensitivity and 82.8% specificity in differentiating preeclamptic women from healthy pregnant women.
The serum sFlt-1/Ang-2 ratio is significantly elevated in preeclamptic women as compared to healthy pregnant women. Remarkable difference of sFlt-1/Ang-2 ratio between these two groups with excellent specificity and sensitivity suggests the clinical usefulness of the serum sFlt-1/Ang-2 ratio in diagnosing and potentially predicting the onset of preeclampsia.
血管生成相关因子的失衡可能易引发子痫前期。在此,我们测定了子痫前期女性血清中可溶性fms样酪氨酸激酶1(sFlt-1,促血管生成的血管内皮生长因子(VEGF)的天然抑制剂)浓度与血管生成素-2(Ang-2,血管生成素-1(Ang-1)的天然拮抗剂,在VEGF存在时参与促进血管生成)浓度的比值。
采用酶联免疫吸附测定法检测血清sFlt-1和Ang-2水平。
与健康孕妇相比,子痫前期女性血清Ang-2显著降低,sFlt-1升高。与健康孕妇相比,子痫前期女性血清sFlt-1/Ang-2比值显著升高,而健康孕妇该比值较低,与非孕妇相似。子痫前期女性血清sFlt-1浓度与平均血压(BP)呈正相关趋势,但健康孕妇中无此相关性。血清sFlt-1/Ang-2比值>0.25时,区分子痫前期女性与健康孕妇的敏感度为87.1%,特异度为82.8%。
与健康孕妇相比,子痫前期女性血清sFlt-1/Ang-2比值显著升高。这两组之间sFlt-1/Ang-2比值存在显著差异,且具有良好的特异度和敏感度,提示血清sFlt-1/Ang-2比值在诊断和潜在预测子痫前期发病方面具有临床应用价值。