Angiogenic imbalance as a contributor to the pathophysiology of preeclampsia among black African women

Abstract

Objective: The pathogenesis of preeclampsia remains unclear despite extensive research. Altered angiogenic balance has been hypothesized to play a significant role in the clinical manifestations of this syndrome. However this imbalance has not been investigated extensively among black African women. The aim of this study was to investigate the maternal levels of the angiogenic factors soluble vascular endothelial growth factor receptor 1 (sFLT1) and placental growth factor (PlGF) among black African women with preeclampsia.

Methods: A case control study was conducted in the Mthatha hospital complex in South Africa including 51 women with preeclampsia and 82 women with uncomplicated pregnancies. Blood samples were drawn from participants and serum was used to assess sFLT1, and PlGF levels quantified using specific enzyme linked immunosorbent assays. Non- parametric statistics were used for analysis.

Results: Black African women with preeclampsia were found to have significantly lower levels of PlGF (90.3 ± 8.9 pg/ml versus 172.8 ± 20.2 pg/ml; p < 0.01), higher sFLT1 (2087.3 ± 200.1 pg/ml versus 1546.5 ± 91.9 pg/ml; p < 0.01) and a higher sFLT1/PIGF ratio (66.8 ± 18.7 versus 22.3 ± 2.9; p < 0.01) compared to black African normotensive controls.

Conclusion: The results support an altered angiogenic balance may contribute to the pathogenesis/pathophysiology of preeclampsia among black African women as reported in other populations.

Keywords: Angiogenic factors; black African women; placental growth factor; preeclampsia; soluble vascular endothelial growth factor 1.