Analysis of SFLT1 in pregnant women taking aspirin

Abstract

Endothelial factors such as soluble Feline McDonough Sarcoma (fms)-like tyrosine kinase-1 (sFLT1) and Placental Growth Factor (PlGF) are involved in the pathogenesis of pre-eclampsia. Their modulation by aspirin may be key to its use in the prevention of pre-eclampsia. The aim of this study is to investigate the effects of aspirin use on sFLT1 and PlGF in women at risk of developing pre-eclampsia. 75 participants were chosen from a cohort of 200+ recruited from Mater Dei Hospital to test the levels of sFLT1 and PlGF in their serum measured by Enzyme-Linked Immunosorbent Assay (ELISA). Statistical analysis found first trimester PlGF to be significantly lower in high risk participants taking aspirin, whilst sFLT1 levels, in all trimesters, in women with aspirin, were not significantly different to those of controls, possibly indicating the protective effect of aspirin. Second trimester sFLT1 results were also found to be significantly higher in women who later developed hypertension, highlighting possible future use as a hypertensive disorder biomarker for Maltese women early in pregnancy. Patient history also indicated lower levels of PlGF, and higher sFLT1/PlGF ratio levels, as indicated in the literature. Aspirin appears to lower sFLT1 levels in women who are at high risk of pre-eclampsia, without affecting their PlGF levels. This is a first indication of sFLT1 not only being a biomarker, but a causative agent of pre-eclampsia in women; its application in a clinical setting varies from a biomarker of pre-eclampsia to potential extracorporeal apheresis of sFLT1 to reduce pathology caused by pre-eclampsia.