TY - JOUR
T1 - A role of the anti-angiogenic factor sVEGFR-1 in the 'mirror syndrome' (Ballantyne's syndrome)
AU - Espinoza, Jimmy
AU - Romero, Roberto
AU - Nien, Jyh Kae
AU - Kusanovic, Juan Pedro
AU - Richani, Karina
AU - Gomez, Ricardo
AU - Kim, Chong Jai
AU - Mittal, Pooja
AU - Gotsh, Francesca
AU - Erez, Offer
AU - Chaiworapongsa, Tinnakorn
AU - Hassan, Sonia
N1 - Funding Information:
This research was supported by the Intramural Research Program of the National Institute of Child Health and Human Development, NIH, DHHS.
PY - 2006/10/1
Y1 - 2006/10/1
N2 - Background. 'Mirror syndrome' (Ballantyne's syndrome) refers to the association of fetal hydrops with placentomegaly and severe maternal edema. Preeclampsia occurs in approximately 50% of these cases. Soluble vascular endothelial growth factor receptor-1 (sVEGFR-1), an anti-angiogenic factor, has been implicated in the pathophysiology of preeclampsia (PE). Objective. The objective of this study was to determine if the maternal plasma concentration of sVEGFR-1 is elevated in patients with mirror syndrome. Study design. This case-control study included patients with uncomplicated pregnancies (n=40) and those with mirror syndrome (n=4) matched for gestational age. Mirror syndrome was defined as fetal hydrops and severe maternal edema. Maternal plasma sVEGFR-1 concentrations were determined using specific enzyme-linked immunosorbent assays. Immunohistochemistry of sVEGFR-1 on villous trophoblasts was also performed in samples from one patient with mirror syndrome and compared with those from a patient with spontaneous preterm delivery matched for gestational age. Non-parametric statistics were used for analysis (p<0.05). Results. (1) The median maternal plasma concentration of sVEGFR-1 was significantly higher in patients with mirror syndrome than in the control group (median: 3974pg/mL, range: 3083-10 780 vs. median: 824pg/mL, range: 260-4712, respectively; p<0.001). (2) All patients with mirror syndrome had sVEGFR-1 concentrations above the 95th percentile for gestational age. Syncytiotrophoblast, especially syncytial knots, showed strong staining with antibodies against sVEGFR-1 in placental samples from the patient with mirror syndrome, but not in those from the patient with spontaneous preterm delivery. Conclusion. High maternal plasma concentrations of sVEGFR-1 were observed in mirror syndrome. We propose that this anti-angiogenic factor may participate in the pathophysiology of this syndrome. Thus, maternal plasma determination of sVEGFR-1 may help to identify the hydropic fetus that places the mother at risk for preeclampsia.
AB - Background. 'Mirror syndrome' (Ballantyne's syndrome) refers to the association of fetal hydrops with placentomegaly and severe maternal edema. Preeclampsia occurs in approximately 50% of these cases. Soluble vascular endothelial growth factor receptor-1 (sVEGFR-1), an anti-angiogenic factor, has been implicated in the pathophysiology of preeclampsia (PE). Objective. The objective of this study was to determine if the maternal plasma concentration of sVEGFR-1 is elevated in patients with mirror syndrome. Study design. This case-control study included patients with uncomplicated pregnancies (n=40) and those with mirror syndrome (n=4) matched for gestational age. Mirror syndrome was defined as fetal hydrops and severe maternal edema. Maternal plasma sVEGFR-1 concentrations were determined using specific enzyme-linked immunosorbent assays. Immunohistochemistry of sVEGFR-1 on villous trophoblasts was also performed in samples from one patient with mirror syndrome and compared with those from a patient with spontaneous preterm delivery matched for gestational age. Non-parametric statistics were used for analysis (p<0.05). Results. (1) The median maternal plasma concentration of sVEGFR-1 was significantly higher in patients with mirror syndrome than in the control group (median: 3974pg/mL, range: 3083-10 780 vs. median: 824pg/mL, range: 260-4712, respectively; p<0.001). (2) All patients with mirror syndrome had sVEGFR-1 concentrations above the 95th percentile for gestational age. Syncytiotrophoblast, especially syncytial knots, showed strong staining with antibodies against sVEGFR-1 in placental samples from the patient with mirror syndrome, but not in those from the patient with spontaneous preterm delivery. Conclusion. High maternal plasma concentrations of sVEGFR-1 were observed in mirror syndrome. We propose that this anti-angiogenic factor may participate in the pathophysiology of this syndrome. Thus, maternal plasma determination of sVEGFR-1 may help to identify the hydropic fetus that places the mother at risk for preeclampsia.
KW - Ballantyne's syndrome
KW - Mirror syndrome
KW - Preeclampsia
KW - Villous edema
KW - sVEGFR-1
UR - http://www.scopus.com/inward/record.url?scp=33751349227&partnerID=8YFLogxK
U2 - 10.1080/14767050600922677
DO - 10.1080/14767050600922677
M3 - Article
C2 - 17118734
AN - SCOPUS:33751349227
SN - 1476-7058
VL - 19
SP - 607
EP - 613
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 10
ER -