Increase in Circulating Endoglin a Marker for Preeclampsia

Combined with other antiangiogenic factors, endoglin strongly predictive for preeclampsia

WEDNESDAY, Sept. 6 (HealthDay News) -- Circulating levels of soluble endoglin increase in women two to three months prior to the development of preeclampsia and the increase occurs along with alterations in soluble antiangiogenic proteins and growth factor ratios, according to a report in the Sept. 7 issue of the New England Journal of Medicine.

Richard J. Levine, M.D., of the National Institute of Child Health and Human Development in Bethesda, Md., and colleagues performed a nested case-control study of healthy nulliparous women enrolled in the Calcium for Preeclampsia Prevention trial. The study included 72 women with preterm preeclampsia and 480 other women (120 with preeclampsia at term, 120 with gestational hypertension, 120 normotensive women who delivered small-for-gestational-age infants, and 120 normotensive controls who delivered infants not small for their gestational age).

The authors report that circulating soluble endoglin increased markedly starting two to three months before preeclampsia; after disease onset, a difference was seen in the mean serum levels between women with preterm preeclampsia (46.4 ng/mL) compared with controls (9.8 ng/mL). The mean serum level in women with preeclampsia was 31.0 ng/mL compared with 13.3 ng/mL in controls. An increased ratio of soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor usually accompanied increased levels of endoglin.

"Taken together with experimental evidence in rodents, these data suggest that circulating soluble endoglin and sFlt1, each of which causes endothelial dysfunction by a different mechanism, may both contribute to the syndrome of preeclampsia. Prospective longitudinal studies are needed to assess whether these biomarkers can predict the imminent onset of clinical disease," the authors conclude.

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