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Study demonstrates altered angiogenic proteins in preeclampsia patients

BOSTON -- The discovery that a protein "marker" is sharply elevated approximately five weeks prior to the onset of preeclampsia could provide a warning sign to help doctors in diagnosing this potentially life-threatening complication of pregnancy. Led by researchers at Beth Israel Deaconess Medical Center (BIDMC) and the National Institute of Child Health and Development (NICHD), the study appears in the February 12 issue of The New England Journal of Medicine.

Preeclampsia typically develops after the 20th week of pregnancy and is characterized by high blood pressure, edema and protein in the urine. However, in severe cases, it can without warning rapidly escalate to eclampsia, a condition in which the mother suffers serious and potentially fatal seizures. There are currently no blood tests available to help physicians diagnose these patients prior to the onset of clinical symptoms.

"Our new findings might allow doctors to closely monitor these high-risk patients and identify preeclampsia at an earlier stage," explains co-senior author S. Ananth Karumanchi, MD, of the Renal Division at BIDMC and Assistant Professor of Medicine at Harvard Medical School (HMS). Also known as toxemia, preeclampsia occurs in an estimated five percent of all pregnancies, and affects approximately 200,000 women in the U.S. each year. Worldwide, it is one of the leading causes of maternal and infant mortality.

Last year, Karumanchi and colleagues identified the source of the disease as being a protein known as soluble fms-like tyrosine kinase 1 (sFlt1). Released by the mother's placenta, sFlt1 is believed to trigger the symptoms of preeclampsia when it binds to and "mops up" another group of proteins placental growth factor (PGF) and vascular endothelial growth factor (VEGF). PGF and VEGF exist to promote angiogenesis, the growth of small blood vessels.

"What appears to be happening [in cases of preeclampsia] is that blood vessels to the placenta become n
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Contact: Bonnie Prescott
bprescot@bidmc.harvard.edu
617-667-7306
Beth Israel Deaconess Medical Center
5-Feb-2004


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