PLGF
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- MeSH
- lidé MeSH
- mladý dospělý MeSH
- placentární růstový faktor analýza MeSH
- preeklampsie * diagnóza MeSH
- prenatální diagnóza metody MeSH
- receptor 1 pro vaskulární endoteliální růstový faktor analýza MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
INTRODUCTION: Pre-eclampsia affects ~5%-7% of pregnancies. Although improved obstetric care has significantly diminished its associated maternal mortality, it remains a leading cause of maternal morbidity and mortality in the world. Term pre-eclampsia accounts for 70% of all cases and a large proportion of maternal-fetal morbidity related to this condition. Unlike in preterm pre-eclampsia, the prediction and prevention of term pre-eclampsia remain unsolved. Previously proposed approaches are based on combined third-trimester screening and/or prophylactic drugs, but these policies are unlikely to be widely implementable in many world settings. Recent evidence shows that the soluble fms-like tyrosine kinase-1 (s-Flt-1) to placental growth factor (PlGF) ratio measured at 35-37 weeks' gestation predicts term pre-eclampsia with an 80% detection rate. Likewise, recent studies demonstrate that induction of labour beyond 37 weeks is safe and well accepted by women. We hypothesise that a single-step universal screening for term pre-eclampsia based on sFlt1/PlGF ratio at 35-37 weeks followed by planned delivery beyond 37 weeks reduces the prevalence of term pre-eclampsia without increasing the caesarean section rates or worsening the neonatal outcomes. METHODS AND ANALYSIS: We propose an open-label randomised clinical trial to evaluate the impact of a screening of term pre-eclampsia with the sFlt-1/PlGF ratio followed by planned delivery in asymptomatic nulliparous women at 35-37 weeks. Women will be assigned 1:1 to revealed (sFlt-1/PlGF known to clinicians) versus concealed (unknown) arms. A cut-off of >90th centile is used to define the high risk of subsequent pre-eclampsia and offer planned delivery from 37 weeks. The efficacy variables will be analysed and compared between groups primarily following an intention-to-treat approach, by ORs and their 95% CI. This value will be computed using a Generalised Linear Mixed Model for binary response (study group as fixed effect and the centre as intercept random effect). ETHICS AND DISSEMINATION: The study is conducted under the principles of Good Clinical Practice. This study was accepted by the Clinical Research Ethics Committee of Hospital Clinic Barcelona on 20 November 2020. Subsequent approval by individual ethical committees and competent authorities was granted. The study results will be published in peer-reviewed journals and disseminated at international conferences. TRIAL REGISTRATION NUMBER: NCT04766866.
- MeSH
- biologické markery MeSH
- císařský řez MeSH
- lidé MeSH
- multicentrické studie jako téma MeSH
- novorozenec MeSH
- placentární růstový faktor MeSH
- prediktivní hodnota testů MeSH
- preeklampsie * diagnóza prevence a kontrola epidemiologie MeSH
- randomizované kontrolované studie jako téma MeSH
- receptor 1 pro vaskulární endoteliální růstový faktor MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- protokol klinické studie MeSH
INTRODUCTION: The aim of the study was to identify predictive values of the soluble fms-like tyrosine kinase/placental growth factor (sFlt-1/PlGF) ratio and interleukin (IL)-6, assessed with a clinically available method in a large-volume biochemistry laboratory, in maternal blood, amniotic fluid, and umbilical cord blood for the presence of the placental lesions consistent with maternal vascular malperfusion (MVM) and acute histological chorioamnionitis (HCA), respectively. METHODS: This retrospective study included 92 women with preterm labor with intact membranes (PTL) delivered within 7 days of admission with gestational ages between 22+0 and 34+6 weeks. The sFlt-1/PlGF ratio and IL-6 were assessed in stored samples of maternal serum, amniotic fluid, and umbilical cord serum using Elecsys® sFlt-1, PlGF, and IL-6 immunoassays. RESULTS: Women with MVM had a higher sFlt-1/PlGF ratio in the maternal serum, compared to those without MVM (19.9 vs. 4.6; p < 0.0001), but not in the amniotic fluid or umbilical cord blood. A cut-off value of 8 for the sFlt-1/PlGF ratio in maternal serum was identified as optimal for predicting MVM in patients with PTL. Women with HCA had higher concentrations of IL-6 in maternal serum, compared to those without HCA (11.1 pg/mL vs. 8.4 pg/mL; p = 0.03), amniotic fluid (9,216 pg/mL vs. 1,423 pg/mL; p < 0.0001), and umbilical cord blood (20.7 pg/mL vs. 10.7 pg/mL, p = 0.002). Amniotic-fluid IL-6 showed the highest predictive value. A cut-off value of IL-6 concentration in the amniotic fluid of 5,000 pg/mL was found to be optimal for predicting HCA in PTL. CONCLUSION: Maternal serum sFlt-1/PlGF and amniotic fluid IL-6 concentrations can be used for liquid biopsy to predict placental lesions in women with PTL who deliver within 7 days.
- MeSH
- biologické markery krev MeSH
- chorioamnionitida krev diagnóza MeSH
- dospělí MeSH
- fetální krev metabolismus MeSH
- interleukin-6 * krev MeSH
- lidé MeSH
- placenta metabolismus MeSH
- placentární růstový faktor * krev MeSH
- plodová voda metabolismus MeSH
- předčasná porodní činnost * krev MeSH
- prediktivní hodnota testů * MeSH
- receptor 1 pro vaskulární endoteliální růstový faktor * krev MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cíl studie: Cílem této práce bylo popsat plazmatické hladiny placentárního růstového faktoru (PLGF) u pacientek s patologickými stavy v těhotenství. Typ studie: Case-control studie. Název a sídlo pracoviště: Ústav lékařské biochemie a laboratorní diagnostiky 1. LF UK a VFN, Kateřinská 32, 121 08 Praha 2. Materiál a metody: Sledovaná skupina byla složena ze 151 žen ve třetím trimestru těhotenství (35 pacientek s příznaky předčasného porodu, 32 pacientek s gestační hypertenzí, 30 pacientek s růstovou retardací plodu (IUGR), 13 pacientek s intrahepatickou cholestázou v těhotenství (ICP) a 41 zdravých těhotných žen sloužících jako kontroly). PLGF byl měřen metodou ELISA. Výsledky: U pacientek s gestační hypertenzí a IUGR byly zjištěny signifikantně snížené hladiny PLGF ve srovnání s kontrolami (90,6 (IQR 49,9 – 122,4) pg/ml, resp. 56,0 (IQR 39,6 – 143,1) pg/ml vs. 183,9 (IQR 114,0 – 302,2) pg/ml, p < 0,0001), přičemž hladiny PLGF u pacientek s předčasným porodem a ICP se od kontrolní skupiny nelišily. Po adjustaci na gestační věk se od kontrol signifikantně lišily všechny skupiny pacientek. Byla prokázána negativní korelace hladiny PLGF jak s počtem erytrocytů, tak i s hladinou hemoglobinu u pacientek s hrozícím předčasným porodem (r = – 0,46 p = 0,0058, resp. r = –0,53, p = 0,0013) a dále pak s hladinou kyseliny močové u pacientek s IUGR (r = – 0,4237, p = 0,0196). Závěr: Výsledky studie přispívají k lepšímu porozumění patologických mechanizmů u rizikového těhotenství.
Objective: The aim of the study was to investigate placental growth factor (PLGF) plasma levels in patients with pathological states in pregnancy. Design: Case-control study. Settings: Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Kateřinská 32, 121 08 Prague, Czech Republic. Material and Methods: The studied group consisted of together 151 women in the third trimester of pregnancy (35 patients with threatening preterm labor, 32 patients with hypertensive disorder, 30 patients with intrauterine growth restriction (IUGR), 13 patients with pregnancy intrahepatic cholestasis (ICP) and 41 healthy pregnant controls). PLGF was measured by ELISA. Results: Patients with preeclampsia and IUGR had significantly decreased PLGF levels compared to controls, (90.6 (IQR 49.9 – 122.4) pg/ml; resp. 56.0 (IQR 39.6 – 143.1) pg/ml vs. 183.9 (IQR 114.0 – 302.2) pg/ml, p < 0.0001), whereas PLGF levels in patients with preterm labor and ICP did not differ from control group. After gestational age adjustment, all groups of patients significantly differ from control group. PLGF correlates negatively with both erythrocyte count and hemoglobin levels in patients with preterm labor (r = –0.46 p = 0.0058 resp. r = – 0.53, p = 0.0013) and with uric acid in patients with IUGR (r = – 0.4237, p = 0.0196). Conclusion: Results of the study contribute to better understanding of the pathological mechanisms in risk pregnancy.
- MeSH
- biologické markery krev MeSH
- časové faktory MeSH
- dospělí MeSH
- lidé MeSH
- placentární růstový faktor * krev MeSH
- předčasný odtok plodové vody * MeSH
- receptor 1 pro vaskulární endoteliální růstový faktor * krev MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- MeSH
- biologické markery MeSH
- lidé MeSH
- novorozenec MeSH
- placentární růstový faktor MeSH
- předčasná porodní činnost * MeSH
- prediktivní hodnota testů MeSH
- preeklampsie * MeSH
- receptor 1 pro vaskulární endoteliální růstový faktor MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- dopisy MeSH
Background: Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are used in diagnosing preeclampsia (PE), but their potential in early prediction in pregnant women at 16 to 20 weeks gestation (WG) has remained unexplored. Methods: We retrospectively measured serum levels of sFlt-1 and PlGF in 120 pregnant women at 16 to 20 WG. Among these women, 16 had early-onset PE and 23 had late-onset PE. Results: Compared with normal pregnancy values, in the serum of women in whom PE later developed, sFlt-1 values increased (P <.001), values of PlGF decreased (P = .001), and the sFlt-1/PlGF ratio increased (P <.001) as early as 16 to 20 WG. Receiver operating characteristic (ROC) curve analysis for the sFlt-1/PlGF ratio at 16 to 20 WG showed an area under the curve (AUC) value of 0.863 (95% confidence interval [CI], 0.788-0.918), P <.001, sensitivity of 74.4%, and specificity of 86.6% for PE in general; and AUC of 0.970 (95% CI, 0.913-0.994), P <.001, sensitivity of 100%, and specificity of 81.5% for early-onset PE only. Also, we determined the 5th and 95th percentiles for sFlt-1, PlGF, and sFlt-1/PlGF ratio values of healthy pregnant women. Conclusion: sFlt-1 and PlGF and, in particular, the sFlt-1/PlGF ratio can detect PE as early as 16 to 20 WG-as long as 10 to 15 weeks before PE onset.
- MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- placentární růstový faktor krev MeSH
- preeklampsie krev diagnóza MeSH
- receptor 1 pro vaskulární endoteliální růstový faktor krev MeSH
- retrospektivní studie MeSH
- senzitivita a specificita MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND/AIM: To evaluate the diagnostic accuracy and prognostic performance of urinary and plasma levels of placental growth factor (PLGF) and provide their comparison with the results of vascular endothelial growth factor A (VEGF-A) in patients with primary and recurrent urinary bladder cancer. MATERIALS AND METHODS: The enzyme-linked immunosorbent assay (ELISA) was used to assess urinary and plasma concentrations of PLGF and VEGF-A in 240 individuals. RESULTS: PLGF levels in urine and plasma were significantly higher in patients with primary bladder cancer than in healthy individuals (p=0.003, p=0.005, respectively). Area under the curve (AUC) of urinary PLGF was 0.68; AUC of plasma PLGF levels was 0.65. Patients with the urine levels of PLGF higher than 82.33 pg/ml had three times higher risk of recurrence. In patients with recurrent bladder cancer, the urinary concentrations of PLGF did not significantly differ from the concentrations in patients without current disease (p=0.61). However, plasma PLGF levels were significantly higher in patients diagnosed with tumor recurrence (p=0.001); AUC of plasma PLGF levels was 0.69. Moreover, patients with plasma levels higher than 10.09 pg/ml had a five-times higher risk of future tumor recurrence. The diagnostic accuracy of PLGF was comparable with VEGF-A. CONCLUSION: From a clinical point of view, PLGF could be considered a valid diagnostic test for the detection of primary and recurrent bladder cancer. In patients with recurrent bladder cancer, plasma PLGF levels can differentiate individuals at risk of tumor recurrence.
PURPOSE: The aim of this study was to investigate whether there is any association between the levels of the angiogenic growth factors and the vascular oxygen saturation in eyes with diabetic retinopathy. METHODS: The study was designed as a prospective trial. The cohort consisted of 29 diabetic patients with scheduled vitreous procedures (intravitreal injection or pars plana vitrectomy). The control group included 30 patients scheduled for macular surgery (macular hole or epiretinal membrane). Nine patients (four from the diabetic maculopathy [DM] group and five from the control group) were excluded from the study because of unsuccessful vitreous samples. Retinal oximetry was performed several hours before the vitreous procedure was performed, and vitreous samples were obtained during the procedure. The concentrations of VEGF, Serpin F1/pigment epithelium-derived factor (PEDF), and placental growth factor (PlGF) were measured by ELISA. RESULTS: A negative correlation between level of VEGF and arteriovenous (AV) saturation difference was determined in the DM group (Pearson correlation coefficient r = -0.607; two-tailed test, P = 0.002). Also a negative correlation between level of PlGF and AV saturation difference was determined in the DM group (Pearson correlation coefficient r = -0.521; two-tailed test, P = 0.011) A positive correlation between PlGF level and the vein saturation was not statistically significant (Pearson correlation coefficient r = 0.325; two-tailed test, P = 0.130). We did not find any correlation between vitreous level of PEDF and vascular saturation within the DM group. CONCLUSIONS: Our findings in diabetic patients suggests a correlation between the intravitreal level of proangiogenic factors and the AV difference measured by retinal oximetry.
- MeSH
- diabetes mellitus * MeSH
- diabetická retinopatie * MeSH
- lidé MeSH
- placentární růstový faktor MeSH
- prospektivní studie MeSH
- retina MeSH
- retinální cévy MeSH
- saturace kyslíkem MeSH
- vaskulární endoteliální růstový faktor A MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
