Nieuwe inzichten in pathogenese van pre-eclampsie

De rol van angiogeneseremmende factoren
Stand van zaken
Koen Verdonk, Willy Visser, Eric A.P. Steegers, Mariëtte H.W. Kappers, A.H. Jan Danser en Anton H. van den Meiracker

New insights into the pathogenesis of pre-eclampsia: the role of angiogenesis-inhibiting factors

  • The pathogenesis of pre-eclampsia is biphasic. The first phase is characterised by insufficient placentation and the second phase by an increased placental release of 2 anti-angiogenic factors, namely, soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble endoglin (sEng).

  • Within maternal circulation, sFlt-1 and sEng inhibit the effects of vascular endothelial growth factor (VEGF) and transforming growth factor β (TGFβ). This results in endothelial cell activation and inflammation, and eventually leads to the clinical syndrome of pre-eclampsia.

  • The rise in plasma concentrations of sFlt-1 and sEng precedes the development of pre-eclampsia with 6-8 weeks.

  • Whether elevations in the plasma concentrations of sFlt and sEng, combined with a decrease in placental growth factor concentrations, can be utilised as a predictor for pre-eclampsia is currently under investigation.

  • Conflict of interest: none declared. Financial support: none declared.