Angiogenic factors in pregnancies of women with antiphospholipid syndrome and systemic lupus erythematosus. (June 2018)

• Record Type: Journal Article
• Authors: Mayer-Pickel, Karoline; Stern, Christina; Eberhard, Katharina; Lang, Uwe; Obermayer-Pietsch, Barbara; Cervar-Zivkovic, Mila
• Is Part Of: Journal of reproductive immunology. Volume 127(2018)
• Page Start: 19
• Page End: 23
• Publication Date: 2018-06
• Subjects: Antiphospholipid syndrome -- Systemic lupus erythematosus -- Pregnancy -- Preeclampsia -- sFlt-1/PlGF-ratio; Reproduction -- Immunological aspects -- Periodicals; Immunology -- Periodicals; Allergy and Immunology -- Periodicals; Reproduction -- Periodicals; Reproduction -- Immunologie -- Périodiques; Immunologie -- Périodiques; Immunology; Reproduction -- Immunological aspects; Periodicals; Electronic journals; Electronic journals; 615.766
• DOI: 10.1016/j.jri.2018.04.002
• Languages: English
• ISSNs: 0165-0378

Abstract

Highlights: The antiphospholipid syndrome and systemic lupus erythematosus have an increased risk of developing especially preeclampsia in pregnancy. Measurement of sFlt-1, PGlF and endoglin starting at early gestation optimizes the obstetric management and might improve the obstetric outcome. Regular measurements of sFlt-1 and PlGF especially as a matter of routine should be an essential part of obstetric management. Abstract: Objectives: An imbalance of angiogenic placental factors such as endoglin, soluble fms-like tyrosine kinase 1(sFlt-1) and placental growth factor (PlGF) has been implicated in the pathophysiology of preeclampsia. This study aimed to evaluate serum levels of sFlt-1, PlGF and endoglin in women with primary and secondary antiphospholipid Syndrome (APS) and systemic lupus erythematosus (SLE) longitudinally through pregnancy. Material and Methods: Serum levels of sFlt-1, PlGF and endoglin were measured prospectively at 4-week intervals (from gestational weeks 12–36) in 17 women with primary APS (PAPS), 18 women with secondary APS (SAPS), and 23 women with SLE. Results: 6/17 (35%) of women with PAPS, 3/18 (17%) of women with SAPS, and 2/23 (9%) of women with SLE developed early-onset preeclampsia. Women who developed preeclampsia had significantly higher mean sFlt-1 and endoglin levels, higher sFlt-1/PlGF ratios, and lower mean PlGF-levels than women who did not. These changes became statistically significant at 12 weeks for sFlt-1, PlGF and endoglin. Discussion: Endoglin, sFlt-1 and PlGF are potential early screening parameters for the development of preeclampsia in pregnant women with autoimmune diseases like APS and SLE.