Angiogenic proteins as aid in the diagnosis and prediction of preeclampsia

Abstract

Preeclampsia/eclampsia remains a major cause of maternal and fetal morbidity worldwide. It also remains a leading cause of iatrogenic prematurity as delivery is currently the only way to successfully treat the disorder. The mechanisms that initiate preeclampsia in humans have been remarkably elusive, but some parts of the puzzle have begun to come together. Recently, it has been suggested that its major phenotypes, such as hypertension, proteinuria and endothelial dysfunction, are due to circulating anti-angiogenic proteins such as soluble fms-like tyrosine kinase-1 and soluble endoglin. Abnormalities in these circulating angiogenic proteins are not only present during clinical preeclampsia, but also antedate clinical symptoms by at least 5–6 weeks. The availability of automated platforms for the measurement of these angiogenic proteins has allowed clinicians to evaluate the role of these biomarkers as an aid in the diagnosis and prediction of preeclampsia. This review will highlight the recent clinical studies that have evaluated the utility of these biomarkers in preeclampsia and its related complications.

Key Words::

• preeclampsia
• angiogenic proteins
• proteinuria
• hypertension
• diagnostic tests

Acknowledgements

S.A.K. is an investigator of the Howard Hughes Medical Institute. The Gulbenkian Programme for Advanced Medical Education is sponsored by Fundação Calouste Gulbenkian, Fundação Champalimaud, Ministério da Saúde e Fundação para a Ciência e Tecnologia, Portugal.