Angiogenic factors in pregnancies of women with antiphospholipid syndrome and systemic lupus erythematosus

Objectives: An imbalance of angiogenic placental factors such as endoglin, soluble fms-like tyrosine kinase 1(sFlt-1) and placental growth factor (PIGF) has been implicated in the pathophysiology of preeclampsia. This study aimed to evaluate serum levels of sFlt-1, P1GF and endoglin in women with primary and secondary antipho-spholipid Syndrome (APS) and systemic lupus erythematosus (SLE) longitudinally through pregnancy. Material and Methods: Serum levels of sFlt-1, PIGF and endoglin were measured prospectively at 4-week intervals (from gestational weeks 12-36) in 17 women with primary APS (PAPS), 18 women with secondary APS (SAPS), and 23 women with SLE. Results: 6/17 (35%) of women with PAPS, 3/18 (17%) of women with SAPS, and 2/23 (9%) of women with SLE developed early-onset preeclampsia. Women who developed preeclampsia had significantly higher mean sFlt-1 and endoglin levels, higher sFlt-1/PIGF ratios, and lower mean PIGF-levels than women who did not. These changes became statistically significant at 12 weeks for sFlt-1, PIGF and endoglin. Discussion: Endoglin, sFlt-1 and P1GF are potential early screening parameters for the development of preeclampsia in pregnant women with autoimmune diseases like APS and SLE.