Ratio of angiogenic and anti-angiogenic factors in preeclampsia

Background. Today preeclampsia remains one of the most serious complications of pregnancy, taking third place in the structure of maternal and perinatal mortality. The basis of the pathogenesis of preeclampsia is endothelial dysfunction. The underlying causes are widely discussed in the scientific literature.

Objective. To evaluate levels of vascular endothelial growth factor, placental growth factor, a soluble receptor‑1 of a vascular endothelial growth factor in pregnancy complicated by preeclampsia.

Design and methods. We enrolled 105 pregnant women at gestation 32–34 weeks. The main group consisted of 17 (16,2 %) women with moderate preeclampsia. Control group included 88 (83,8 %) pregnant women with uncomplicated pregnancy. VEGF was defined by the enzyme-linked immunosorbent assay, PlGF and sVEGF-R1 — by the electro-chemiluminescence immunoassay.

Results. PlGF level was 942,4 ± 241,3 pg/ml in the control group, and 134,9 ± 73,18 pg/ml in the main group (p < 0,01). VEGF level was significantly higher in study group compared the control group: 5,3 ± 1,3 vs. 2,1 ± 0,8 pg/ml, respectively (p < 0,05). sVEGF‑1 in the control group was 2068,3 ± 323,5 pg/ml, in the main group — 9314,3 ± 1381,0 pg/ml (p < 0,001). Normal pregnancy was characterized by the predominance of angiogenic over antiangiogenic factors. In pregnancy complicated by preeclampsia, there was a significant increase in antiangiogenic factors and decrease in angiogenic factors.

Conclusions. The serum levels of angiogenic and antiangiogenic factors differ in pregnant women with and without preeclampsia at 32–34 weeks gestation. Predominance of angiogenic over antiangiogenic factors is found in normal pregnancy, while women with preeclampsia demonstrate significant increase in antiangiogenic factors and decrease in angiogenic factors. Further investigation of biologically active substances in early pregnancy is required in order to find an early predictor of preeclampsia.

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