Clinical significance of sFlt-1/PlGF in the diagnosis and prediction of preeclampsia


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Abstract

The diagnosis of preeclampsia in clinical practice causes certain difficulties due to the non-specificity of symptoms, the polymorphism of the clinical picture, and the discrepancy between the magnitude of clinical symptoms and the severity of multiple organ dysfunction. Therefore, the accurate diagnosis and prediction of preeclampsia is of great importance for practical obstetrics. The paper presents the results of the basic studies devoted to the clinical interpretation of the sFlt-1/PlGF ratio for the diagnosis and prediction of preeclampsia and shows the informative value and significance of the ratio for the objectification of the diagnosis of preeclampsia, as well as the possibility of predicting this obstetric complication according to sFlt-1/PlGF data. It shows the experience of using sFlt-1/PlGF in the obstetric service in the Moscow Region and formulates indications for the study of sFlt-1/PlGF in clinical practice and approaches to its interpretation. Conclusion. The application of sFlt-1/PlGF allows the differential diagnosis of preeclampsia with an exacerbation or a manifestation of a number of somatic diseases that occur with similar clinical symptoms. The use of sFlt-1/PlGF provides an economic effect, by improving the routing and decreasing the number of severe perinatal and maternal outcomes, as well as reducing unjustified hospitalization. sFlt-1/PlGF is an informative marker for the diagnosis and prediction of preeclampsia and its adverse outcomes and can be recommended for use in clinical practice

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About the authors

Vera M. Guryeva

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: helgin99@gmail.com
Dr. Med. Sci., Leading Researcher

Arina A. Travkina

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: arinamamba@mail.ru
PhD, Senior Researcher

Maxim O. Matveev

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: max-mix@mail.ru
graduate student

Ludmila S. Morokhotova

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: ludrikm1982@gmail.com
PhD, doctor

T. S Budykina

Moscow Regional Research Institute of Obstetrics and Gynecology

Yury B. Kotov

Federal Research Center, M.V. Keldysh Institute of Applied Mathematics, Russian Academy of Sciences

Email: kobylazabyla11@yandex.ru
Dr. Sci. (Physics and Mathematics), Leading Researcher

Tatyana A. Semenova

National Research Nuclear University, Moscow Engineering and Physical Institute

Email: kotsem@voxnet.ru
PhD (Physics and Mathematics), Associate Professor

References

  1. Say L., Chou D., Gemmill A., Tunca1р O., Moller A.-B., Daniels J. et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob. Health. 2014; 2: e323-33. https://dx.doi.org/10.1016/S2214-109X(14)70227-X.
  2. Шалина Р.И., Михалева Л.М., Симухина М.А., Коноплянников А.Г., Штабницкий А.М. Особенности течения тяжелых форм преэклампсии в современных условиях. Вопросы гинекологии, акушерства и перинатологии. 2017; 16(6): 16-23. https://dx.doi.org/10.20953/1726-1678-2017-6-16-23.
  3. Sibai B.M., Stella C.L. Diagnosis and management of atypical preeclampsia-eclampsia. Am. J. Obstet. Gynecol. 2009; 200(5): 481. e1-7. https://dx.doi.org/10.1016/j.ajog.2008.07.048.
  4. Сидорова И.С., Никитина Н.А., Унанян А.Л. Преэклампсия и снижение материнской смертности в России. Акушерство и гинекология. 2018; 1: 107-12. [Sidorova I.S., Nikitina N.A., Unanyan A.L. Preeclampsia and reduction of maternal mortality in Russia. Obstetrics and gynecology. 2018; 1: 107-11. (in Russian)]. https://dx.doi.org/10.18565/aig.2018.1.107-112.
  5. Maynard S.E., Min J.Y., Merchan J., Lim K.H., Li J., Mondal S. et al. Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J. Clin. Invest. 2003; 111(5): 649-58. https://dx.doi.org/10.1172/JCI17189.
  6. Levine R.J., Lam C., Qian C., Yu K.F., Maynard S.E., Sachs B.P. et al. Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. N. Engl. J. Med. 2006; 355(10): 992-1005. https://dx.doi.org/10.1056/NEJMoa055352.
  7. Ahmad S., Ahmed A. Elevated placental soluble vascular endothelial growth factor receptor-1 inhibits angiogenesis in preeclampsia. Circ. Res. 2004; 95(9): 884-91. https://dx.doi.org/10.1161/01.RES.0000147365.86159.f5.
  8. Palm M., Basu S., Larsson A., Wernroth L., Kerud H., Axelsson O. A longitudinal study of plasma levels of soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF), sFlt1: PlGF ratio and vascular endothelial growth factor (VEGF-A) in normal pregnancy. Acta Obstet. Gynecol. Scand. 2011; 90(11): 1244-51. https://dx.doi.org/10.1111/j.1600-0412.2011.01186.x.
  9. Иванец Т.Ю., Алексеева М.Л., Логинова Н.С., Колодько В.Г., Насонова Д.М., Хасьянова З.Ш. Плацентарный фактор роста и fms-подобная тирозинкина-за-1 как маркеры преэклампсии в динамике беременности. Клиническая лабораторная диагностика. 2013; 8: 14-7.
  10. Verlohren S., Galindo A., Schlembach D., Zeisler H., Herraiz I., Moertl M.G. et al. An automated method for the determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia. Am. J. Obstet. Gynecol. 2010; 202(2): 161. e1. 161. e11. https://dx.doi.org/10.1016/j.ajog.2009.09.016.
  11. Verlohren S., Herraiz I., Laрaire O., Schlembach D., Moertl M., Zeisler H. et al. The sFlt-1/PlGF ratio in different types of hypertensive pregnancy disorders and its prognostic potential in preeclamptic patients. Am. J. Obstet. Gynecol. 2012; 206(1): 58. e1-8. https://dx.doi.org/10.1016/j.ajog.2011.07.037.
  12. Rana S., Powe C.E., Salahuddin S., Verlohren S., Perschel F.H., Levine R.J. et al. Angiogenic factors and the risk of adverse outcomes in women with suspected preeclampsia. Circulation. 2012; 125(7): 911-9. https://dx.doi.org/10.1161/ CIRCULATIONAHA.111.054361.
  13. Gomez-Arriaga P., Herraiz I., Loрez-Jimenez E.A., Escribano D., Denk B., Galindo A. Uterine artery Doppler and sFlt-1/PlGF ratio: prognostic value in early-onset preeclampsia. Ultrasound Obstet. Gynecol. 2014; 43(5): 525-32. https://dx.doi.org/10.1002/uog.13224.
  14. Курцер М.А., Шаманова М.Б., Синицына О.В., Николаев А.А., Николаева Е.В., Дедловская А.И., Самсонова М.А. Использование тест-системы Elecsys PlGF и sFLT-1 с целью прогнозирования перинатальных исходов у пациенток с тяжелой преэклампсией. Акушерство и гинекология. 2019; 10: 96-104. https://dx.doi.org/10.18565/aig.2019.10.162-170.
  15. Verlohren S., Herraiz I., Laрaire O., Schlembach D., Zeisler H., Calda P. et al. New gestational phase- specific cutoff values for the use of the soluble fms-like tyrosine kinase-1/placental growth factor ratio as a diagnostic test for preeclampsia. Hypertension. 2014; 63(2): 346-52. https://dx.doi.org/10.1161/ HYPERTENSIONAHA.113.01787.
  16. Simon E., Permuy C., Sacristan L., Zamoro-Lorenci M.J., Villalain C., Galindo A., Herraiz I. sFlt-1/PlGF ratio for the prediction of delivery within 48 hours and adverse outcomes in expectantly managed early-onset preeclampsia. Pregnancy Hypertens. 2020; 22: 17-23. https://dx.doi.org/10.1016/j.preghy.2020.07.007.
  17. Tasta O., Parant O., Hamdi S.M., Allouche M., Vayssiere C., Guerby P. Evaluation of the prognostic value of the sFlt-1/PlGF ratio in early-onset preeclampsia. Am. J. Perinatol. 2020 May 23. https://dx.doi.org/10.1055/s-0040-1709696.
  18. Zeisler H., Llurba E., Chantraine F., Vatish M., Staff A. C., Sennstrom M. et al. Predictive value of the sFlt-1:PlGF ratio in women with suspected preeclampsia. N. Engl. J. Med. 2016; 374(1): 13-22. https://dx.doi.org/10.1056/ NEJMoa1414838.
  19. Bian X., Biswas A., Huang X., Lee K., Kwok-To Li T., Masuyama H. et al. Shortterm prediction of adverse outcomes using the sFlt-1 (Soluble fms-Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) ratio in Asian women with suspected preeclampsia. Hypertension. 2019; 74(1): 164-72. https://dx.doi.org/10.1161/ HYPERTENSIONAHA.119.12760.
  20. Sabria E., Lequerica-Fernandez P., Ganuza P.L., Angeles E.E., Escudero A.I., Martinez-Morillo E., Alvarez F.V. Use of the sFlt-1/PlGF ratio to rule out preeclampsia requiring delivery in women with suspected disease. Is the evidence reproducible? Chem. Lab. Med. 2018; 56(2): 303-11. https://dx.doi.org/10.1515/cclm-2017-0443.
  21. Курцер М.А., Шаманова М.Б., Синицина О.В., Николаева А.А., Дедловская А.И., Самсонова М.А. Клиническое обоснование определения соотношения sFlt-1/PlGF с целью раннего выявления и оценки степени тяжести преэклампсии. Акушерство и гинекология. 2018; 11: 114-20. doi.org/10.18565/ aig.2018.11.114-120.
  22. Ходжаева З.Х., Холин А.М., Шувалова М.П., Иванец Т.Ю., Демура С.А., Галичкина И.В. Российская модель оценки эффективности теста на преэклампсию sFlt-1/PlGF. Акушерство и гинекология. 2019; 2: 52-8. [Khodzhaeva Z.S., Kholin A.M., Shuvalova M.P., Ivanets T.Yu., Demura S.A., Galichkina I.V. A Russian model for evaluating the efficiency of the sFlt-1/PlGF test for preeclampsia. Obstetrics and Gynecology. 2019; 2: 52-8. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.2.52-58
  23. Беженарь В.Ф., Смирнов А.В., Тимирбулатов Р.Р., Габелова К.А., Шапкайц В.А., Нестеров И.М. Почечная дисфункция при преэклам псии: прогнозирование и дифференциальный диагноз. Часть 1. Доктор. Ру. 2020; 19(6): 23-9. https://dx.doi.org/10.31550/1727-2378-2020-19-6-23-29.
  24. Никольская И.Г., Прокопенко Е.И., Ватазин А.В., Будыкина Т.С. Ангиогенные и антиангиогенные факторы у беременных с хронической болезнью почек: роль коэффициента sFlt-1/PlGF в прогнозировании и диагностике преэклампсии. Нефрология и диализ. 2016; 18(4): 440-51.
  25. Agrawal S., Cerdeira A. S., Redman C., Vatish M. Meta-ana lysis and systematic review to assess the role of soluble FMS-like tyrosinekinase-1 and placenta growth factor ratio in prediction of preeclampsia: the SaPPPhirE study. Hypertension. 2018; 71(2): 306-16. https://dx.doi.org/10.1161/ HYPERTENSI0NAHA.117.10182.
  26. Приказ Министерства здравоохранения Московской области № 1072 от 23.07.2018 «Об организации работы по раннему скринингу преэклампсии у беременных в Московской области».
  27. Stepan H., Hund M., Dilba P., Sillman J., Schlembach D. Elecsys® and Kryptor immunoassays for the measurement of sFlt-1 and PlGF to aid preeclampsia diagnosis: are they comparable? Clin. Chem. Lab. Med. 2019; 57(9): 1339-48. https://dx.doi.org/10.1515/cclm-2018-1228.
  28. Резолюция Совета экспертов «Нормативный регламент и вопросы организации скрининга и прогнозирования преэклампсии в РФ». Акушерство и гинекология. 2021; 5: 219-21. [Resolution of the Council of Experts "Regulatory guidelines and issues relating to the organization of screening and prediction of preeclampsia in the Russian Federation". Obstetrics and Gynecology. 2021; 5: 219-21. (in Russian)]. https://dx.doi.org/10.18565/aig.2021.5.219-221.

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