Before and After Preeclampsia: What Biomarkers are there?

Abstract

Preeclampsia is now recognized as a risk factor for developing cardiovascular and renal disease in the mother later in life. Recently, certain substances have been identified, that are be either over- or under-expressed in patients with preeclampsia. One of these biomarkers that is over-expressed in the maternal blood is a soluble VEGF receptor, sFlt1. During the first third trimester of that pregnancies which will evolve in preeclampsia, sFtl1 is higher compared to normal; this increase correlates positively with the severity of the disease and decreases significantly after the birth. It has also been demonstrated that a soluble form of endoglin is produced and released into the maternal circulation in women with preeclampsia. This substance is capable of inhibiting the endothelial effects of TGF β 1. It is consistently elevated in women that will develop preeclampsia. Recently two other early markers have been studied: neutrophil gelatinase-associated lipocalin (NGAL) and pregnancyassociated plasma protein A (PAPP-A). The serum concentrations of NGAL appear to be higher in preeclampsia as compared to normal pregnancies and significant differences are seen in each trimester. Decreased levels of PAPP-A in the first trimester appear to be a sensitive marker for early onset preeclampsia in which placental damage occurs. In this review we try to give a look to this pathology and to the biomarkers that might be involved. Keywords: Ngal, preeclampsia, PAPPA-A, m-RNA, cardiovascular and renal disease, RISK FACTORS IN PREMATURE INFANTS, serum concentrations, pregnancies