Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Hum Hypertens. 2012 Apr;26(4):236-41. doi: 10.1038/jhh.2011.29. Epub 2011 Mar 31.
Placental overproduction of anti-angiogenic soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) has a key role in the development of preeclampsia (PE). Circulating endothelin-1 (ET-1) levels are also elevated in PE. In this study, we investigated the correlation between ET-1 and sFlt-1, placental growth factor (PlGF), sEng levels during uncomplicated normotensive pregnancy and PE. A total of 218 pregnant primigravid women were enrolled: 110 with PE and 108 uncomplicated normotensive pregnancies. PE was defined as new onset of elevated blood pressure (BP) >140/90 mm Hg and ≥2+ proteinuria on two occasions after 20 weeks of gestation in previously normotensive pregnant women. Circulating ET-1, sFlt-1, sEng and PlGF levels were estimated using enzyme immunoassays, and correlation between variables was ascertained. Women with PE showed higher levels of sFlt-1 (41.5±15.7 vs 6.15±3.4 ng ml(-1), P<0.001), sEng (84.9±38.8 vs 13.2±6.3 ng ml(-1), P<0.001), ET-1 (1.52±0.55 vs 0.88±0.35 pg ml(-1), P<0.001) and sFlt-1:PlGF ratio (591.1±468.4 vs 18.3±2.1, P<0.001); and lower levels of PlGF (96.3±47.2 vs 497.6±328.2 pg ml(-1), P<0.001). BP levels showed an independent relationship with sFlt-1:PlGF ratio in normotensive pregnant women and with sFlt-1:PlGF ratio and ET-1 in PE. sFlt-1 and sFlt-1:PlGF ratio correlated with proteinuria. ET-1 correlated significantly with sFlt-1, sEng and sFlt-1:PlGF ratio in PE. Our results show an association between elevation of sFlt-1 and sEng and ET-1 in the maternal circulation in PE, and strengthen the possibility that ET-1 may be a mediator in genesis of PE syndrome secondary to anti-angiogenic factors released by the placenta.
胎盘过度产生抗血管生成的可溶性 fms 样酪氨酸激酶-1（sFlt-1）和可溶性内皮糖蛋白（sEng）在子痫前期（PE）的发生发展中起关键作用。PE 患者的循环内皮素-1（ET-1）水平也升高。在这项研究中，我们研究了在正常妊娠和 PE 期间，循环 ET-1 与 sFlt-1、胎盘生长因子（PlGF）和 sEng 水平之间的相关性。共纳入 218 例初产妇：110 例 PE 和 108 例正常血压的妊娠。PE 的定义为：之前血压正常的孕妇在妊娠 20 周后，新出现的血压升高（BP）>140/90mmHg 和≥2+蛋白尿。使用酶联免疫吸附试验估计循环 ET-1、sFlt-1、sEng 和 PlGF 水平，并确定变量之间的相关性。PE 患者的 sFlt-1（41.5±15.7 与 6.15±3.4ng/ml，P<0.001）、sEng（84.9±38.8 与 13.2±6.3ng/ml，P<0.001）、ET-1（1.52±0.55 与 0.88±0.35pg/ml，P<0.001）和 sFlt-1：PlGF 比值（591.1±468.4 与 18.3±2.1，P<0.001）较高，PlGF（96.3±47.2 与 497.6±328.2pg/ml，P<0.001）较低。血压水平与正常妊娠妇女的 sFlt-1：PlGF 比值以及 PE 妇女的 sFlt-1：PlGF 比值和 ET-1 独立相关。sFlt-1 和 sFlt-1：PlGF 比值与蛋白尿相关。ET-1 与 PE 中 sFlt-1、sEng 和 sFlt-1：PlGF 比值显著相关。我们的结果表明，PE 患者母体循环中 sFlt-1 和 sEng 以及 ET-1 的升高之间存在关联，并增强了 ET-1 可能是胎盘释放的抗血管生成因子引起的 PE 综合征发生的介质的可能性。
