Twin-to-twin transfusion syndrome: an antiangiogenic state? - 20/08/11
, Jimmy Espinoza, MD a, c, Jyh Kae Nien, MD e, Chong Jai Kim, MD a, d, Pooja Mittal, MD a, c, Sam Edwin, PhD a, Offer Erez, MD a, Francesca Gotsch, MD a, Shali Mazaki-Tovi, MD c, Nandor G. Than, MD, PhD a, Eleazar Soto, MD c, Natalia Camacho, MD a, c, Ricardo Gomez, MD e, Ruben Quintero, MD f, Sonia S. Hassan, MD a, c
Reprints: Roberto Romero, MD, Perinatology Research Branch, NICHD, NIH, DHHS, Wayne State University/Hutzel Women’s Hospital, 3990 John R, Box 4, Detroit, MI 48201.Résumé |
Objective |
An imbalanced chronic blood flow between the donor and recipient twin through placental vascular anastomoses is the accepted pathophysiology of twin-to-twin transfusion syndrome (TTTS). Vascular endothelial growth factor receptor-1 (VEGFR-1) mRNA is overexpressed only in the syncytiotrophoblast of the donor twin in some cases of TTTS. This study was conducted to determine maternal plasma concentrations of placental growth factor (PlGF), soluble VEGFR-1, and soluble endoglin (s-Eng) in monochorionic-diamniotic pregnancies with and without TTTS.
Study Design |
This case-control study included monochorionic-diamniotic pregnancies between 16-26 weeks with and without TTTS. Maternal plasma concentrations of PlGF, sVEGFR-1, and s-Eng were determined with ELISA. A P value < .05 was considered statistically significant.
Results |
Patients with TTTS had higher median plasma concentrations of s-Eng (14.8 ng/mL vs 7.8 ng/mL; P < .001) and sVEGFR-1 (6383.1 pg/mL vs 3220.1 pg/mL; P < .001]; and lower median plasma concentrations of PlGF (115.5 pg/mL vs 359.3 pg/mL; P = .002) than those without TTTS.
Conclusion |
We propose that an antiangiogenic state may be present in some cases of TTTS.
Le texte complet de cet article est disponible en PDF.Key words : angiogenesis, angiogenic factors, birthweight discordancy, endoglin, monochorionic, placental growth factor, PlGF, sFlt1, sVEGFR-1, TTTS, twin pregnancy
Plan
| This research was supported in part by the Intramural Research Program of the National Institute of Child Health and Human Development, NIH, DHHS. |
|
| Cite this article as: Kusanovic JP, Romero R, Espinoza J, et al. Twin-to-twin transfusion syndrome: an antiangiogenic state? Am J Obstet Gynecol 2008;198:382.e1-382.e8. |
Vol 198 - N° 4
P. 382.e1-382.e8 - avril 2008 Retour au numéro
Article précédent
- Ultrasound prediction of symptomatic congenital cytomegalovirus infection
- Brunella Guerra, Giuliana Simonazzi, Chiara Puccetti, Marcello Lanari, Antonio Farina, Tiziana Lazzarotto, Nicola Rizzo
- Alternative complement pathway activation fragment Bb in early pregnancy as a predictor of preeclampsia
- Anne M. Lynch, James R. Murphy, Tim Byers, Ronald S. Gibbs, Margaret C. Neville, Patricia C. Giclas, Jane E. Salmon, V. Michael Holers
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?