The Study Of The Relationship Between The Soluble Fms-like Tyrosine Kinase 1 (sFlt-1) And Preeclampsia

Objective To investigate the relationship between soluble fms-like tyrosine kinase 1 (sFlt-1) and preeclampsia. Method The levels of sFlt-1 and vascular endothelial growth factor(VEGF) in serum of 30 women with preeclampsia and 45 normal pregnant women were detected by enzyme linked immuosorbent assay. Immunohistochemistry and semi-quantitative RT-PCR were used to investigate the expression of sFlt-1 and sFlt-1mRNA in placentaes of these women. Results (1)The serum level of VEGF of the third trimester group(30.25±3.06ng/L)was higher than that of the first trimester group(27.48±2.67ng/L, P<0.05) but lower than that of the second trimester group(34.14±5.21ng/L, P<0.05);The serum level of sFlt-1 of the third trimester group (7.35 ±3.11mg/L) was higher than that of the first trimester group (4.19±2.17mg/L, P<0.05) and that of the second trimester group(4.42±2.21mg/L, P<0.05).(2) The serum levels of VEGF and sFLT-1 of the normal postpartum group (26.60 ±2.46ng/L> 5.16±239mg/L)were lower than those of the third trimester group (P<0.01,<0.05).(3) The serum level of VEGF of the preeclampsia group (19.29±2.88ng/L) was significantly lower than that of the third trimester group( P<0.01).The serum level of sFLT-1 of the preeclampsia group(30.22±13.69mg/L) was significantly higher than that of the third trimester group(P<0.01).(4) The serum levels of VEGF and sFLT-1 of the preeclampsia postpartum group had no significant difference compared with that of the normal postpartum group(P>0.05).(5) The serum levels of sFLT-1 of the preeclampsia women with the onset before 32 gestation weeks(37.82±13.83mg/L) and with fetal growth retardation(39.07±15.96ng/L) were significantly higher than that of the women with the onset after 32 gestation weeks and not with fatal growth retardation (P<0.05). (6) Positive relationship was shown between the level of sFLT-1 and the 24-hour urinary protein in women with preeclampsia(r=0.517, P<0.01). (7) The mean density of sFLT-1 in preeclampsia placenta(0.156 ± 0.008) was significantly higher than that in the third trimester group(0.143±0.009;P<0.01) and the severe group(0.159 ± 0.008) was higher than the mild group ( 0.151 ± 0.005;P<0.05) . (8)The mRNA expression of sFLT-1 in placenta was significantly higher in preeclampsia group(0.90±0.11) compared with the third trimester group (0.80±0.06;P<0.01) and the severe group(0.93±0.12) was higher than the mild group(0.85±0.05;P<0.05). (9) There was significant correlation between the level of sFlt-1 in serum and the expression of sFlt-lmRNA or the expression of sFlt-1 in placenta of normal pregnancy group ( r=0.314,r=0.439;P<0.05, <0.01 ) andpreeclampsia groups (r=0.372, r=0.383;P<0.05). Conclusion (l)The serum level of sFlt-1 of the preeclampsia group was higher than the normal pregnancy group and correlated with the severity of the desease. (2)Up regulation of sFLT-lmRNA and excess expression of sFlt-1 in placenta may induce higher level of sFlt-1 in serum and then particiate the pathophysiological processes of preeclampsia.