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Substances found in blood may predict development of preeclampsia

t of all pregnancies.

"This is the most promising lead yet in the pursuit of a life-threatening disorder that has defied all attempts to prevent or cure it," said Duane Alexander, M.D., Director of the NICHD. "If we could predict the development of preeclampsia, we could offer treatment before it becomes a serious problem."

In cases where the condition does not progress to eclampsia, infants born to mothers with preeclampsia may be extremely small for their age or may be born prematurely. This may, in turn, place them at risk for a variety of other birth complications.

The Flt-1 molecule belongs to a class of molecules known as receptors, explained the study's principal investigator, Richard Levine, M.D., of NICHD's Division of Epidemiology, Statistics, and Prevention Research. Flt-1 sits on the surface of the cells that line the inside of blood vessels. Like a key fits into a lock, VEGF and PlGF bind to Flt-1, and in the process trigger a chain of chemical reactions inside the cell. The Flt-1 molecule also exists in a soluble form as well, which does not sit on the cell surface but instead circulates in the bloodstream. The soluble Flt-1 (sFlt-1) binds to VEGF and PlGF, preventing them from acting on the cells that line the inside of blood vessels. Pregnant women who carry normal pregnancies to term also have sFlt-1 in their blood. In these women, however, sFlt-1 is present at much lower levels, and much later in the pregnancy-- shortly before birth.

The finding builds upon earlier research led by the study's co-principal investigator, S. Ananth Karumanchi, M.D. of the Renal Division at the Beth Israel Deaconess Medical Center and Harvard Medical School in Boston. Dr. Karumanchi and his coworkers had previously discovered that sFlt-1 circulates in large quantities in the bloodstreams of women with preeclampsia and that sFlt-1 injected into the bloodstream of pregnant rats caused a preeclampsia-like illness.


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Contact: Bob Bock
bockr@mail.nih.gov
301-496-5134
NIH/National Institute of Child Health and Human Development
5-Feb-2004


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