Tagiyeva I, Aliyeva S, Bagirova S, Shamsadinskaya N, Agaeva K
Azerbaijan Medical University, Obstetrics-Gynecology Department II, Baku.
Georgian Med News. 2017 Jul-Aug(268-269):35-38.
The pathophysiology of preeclampsia remains largely unknown. It has been hypothesized that placental ischemia is an early event, leading to placental production of a soluble factor or factors that cause maternal endothelial dysfunction, resulting in the clinical findings of hypertension, proteinuria, and edema. Here, we confirm that placental soluble fms-like tyrosine kinase 1 (sFlt1), an antagonist of vascular growth factor (VEGF) and placental growth factor (PIGF), is upregulated in preeclampsia, leading to increased systemic levels of sFlt1. Our research demonstrate that increased circulating sFlt1 in III trimester in patients with preeclampsia is associated with decreased circulating levels of free VEGF and PIGF, resulting in endothelial dysfunction, comparing with control group. These observations suggest that excess circulating sFlt1 contributes to the pathogenesis of preeclampsia. 45 pregnant women with preeclampsia of different severity degrees were under observation. Control group included 20 healthy pregnant. Pregnant women with preeclampsia were subdivided into 2 groups. There were 11 (24,4%) pregnant with severe degree of preeclamsia (I group), the II group included 34 pregnant with mild degree of preeclampsia. Increased expression of soluble tyrosine kinase-1 (sFlt-1), together with decreased PIGF and VEGF signaling, were first abnormalities described. Thus, determination of levels angiogenic factors: PIGF, VEGF and sFlt-1 is very important for prediction severity of preeclampsia.
子痫前期的病理生理学在很大程度上仍不清楚。据推测,胎盘缺血是早期事件,会导致胎盘产生一种或多种可溶性因子,这些因子会引起母体血管内皮功能障碍,从而导致高血压、蛋白尿和水肿等临床症状。在此,我们证实胎盘可溶性fms样酪氨酸激酶1(sFlt1),一种血管生长因子(VEGF)和胎盘生长因子(PIGF)的拮抗剂,在子痫前期中上调,导致全身sFlt1水平升高。我们的研究表明,与对照组相比,子痫前期患者孕晚期循环中sFlt1升高与游离VEGF和PIGF循环水平降低有关,从而导致血管内皮功能障碍。这些观察结果表明,循环中过量的sFlt1促成了子痫前期的发病机制。对45例不同严重程度子痫前期的孕妇进行了观察。对照组包括20例健康孕妇。子痫前期孕妇被分为2组。有11例(24.4%)重度子痫前期孕妇(I组),II组包括34例轻度子痫前期孕妇。可溶性酪氨酸激酶-1(sFlt-1)表达增加,同时PIGF和VEGF信号传导减少,是最早描述的异常情况。因此,测定血管生成因子PIGF、VEGF和sFlt-1的水平对于预测子痫前期的严重程度非常重要。