关键词: Biomarkers Biomarqueurs Clinical use Endogline soluble Facteurs angiogéniques placentaires Placental angiogenic factors Placental growth factor Pre-existing renal disease Preeclampsia Pré-éclampsie Soluble endoglin Soluble fms-like tyrosine kinase-1 Utilisation clinique Vascular endothelial growth factor

Mesh : Adult Aspirin / therapeutic use Biomarkers / blood Endoglin / physiology Endothelium, Vascular / physiopathology Female Humans Immune Tolerance Inflammation Kidney Diseases / blood surgery Kidney Transplantation Membrane Proteins / blood Oxidative Stress Placenta / immunology metabolism Pre-Eclampsia / blood drug therapy immunology physiopathology Pregnancy Pregnancy Complications / blood Pregnancy Outcome Pregnancy Trimesters Prognosis Transforming Growth Factor beta / physiology Vascular Endothelial Growth Factor A / blood Vascular Endothelial Growth Factor Receptor-1 / blood physiology

来  源:   DOI:10.1016/j.nephro.2018.10.005   PDF(Sci-hub)

Abstract:
The role of angiogenic factors in the onset of clinical manifestations of preeclampsia was demonstrated in 2003 by the implication of sFlt-1, PlGF and VEGF, and in 2006 by the implication of soluble endoglin. Placental ischemia and inflammation observed in preeclampsia alter both the production and progression of angiogenic factors during pregnancy. During the first trimester, the combination of PlGF with clinical, biophysical and biological factors results in a better test than the conventional one. However, the clinical value of this method remains to be confirmed. During the second and third trimesters, the sFlt-1/PlGF ratio may be used, with or without pre-existing renal disease, for short-term prediction, diagnosis, and prognosis, and to evaluate the effectiveness of preeclampsia treatment. While a sFlt-1/PlGF ratio<38 and≤33, respectively, rules out the short-term onset and diagnosis of preeclampsia, a sFlt-1/PlGF ratio≥85 between 20 and 34 weeks of pregnancy and≥110 beyond 34 weeks of pregnancy confirms a diagnosis of preeclampsia. Angiogenic and non-angiogenic preeclampsia are identified by a sFlt-1PlGF≥85 and<85, respectively, with the risk of maternal and fetal complications at two weeks differing between the two. Similarly, a sFlt-1/PlGF ratio>665 and>205, respectively, is a good short-term predictor of adverse outcomes of early and late-onset preeclampsia. These values could be incorporated into future guidelines for better clinical management of preeclampsia.
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