Growth factors in preeclampsia: a vascular disease model. A failed vasodilation and angiogenic challenge from pregnancy onwards?

Cytokine Growth Factor Rev. 2013 Oct;24(5):411-25. doi: 10.1016/j.cytogfr.2013.05.008. Epub 2013 Jun 22.

Abstract

Preeclampsia is the major cause of maternofetal and neonatal morbi-mortality including intrauterine growth retardation, miscarriages and stillbirths. Inadequate vascular dilation and angiogenesis represent the crucial underlying defect of gravidic hypertension, denoting a failed response to the vasodilatory and pro-angiogenic challenge imposed by pregnancy, especially if multifetal. A similar pathogenesis appears involved in gestational diabetes. In this review we aimed to provide a hint on understanding the deeply involved angiogenic disorders which eventually culminate in utero-placental failure. The key players in these complex processes may be found in an intricate network of growth factors (GFs) and GF inhibitors, controlled by several vascular risk factors modulated by environment and genes, which eventually impact on early and late cardiovascular outcomes of mother and fetus.

Keywords: ANP; Angiogenesis; BMI; BV; CI; CO; CRF; EF; FP; GDM; GFs; Growth factors and cytokines; HR; HT; IGF-1; IGFBP-1; IGFBP-3; IGFBP-4; IHD; IUGR; Insulin-like growth factor-1; LV; NO; NO syntetase; NOS; OR; PAPP-A; PE; PG; PI3K; PIH; PlGF; Preeclampsia/pregnancy; RAS; SGA; SMD; SNS; SV; SVR; TGF-β; VEGF; Vasodilation.; atrial natriuretic peptide; blood volume; body mass index; cardiac index; cardiac output; chronic renal failure; eNOS; ejection fraction; endotelial-NO syntetase; fetoplacental; gestational diabetes mellitus; growth factors; heart rate; hypertension; insulin-like growth factor binding protein-1; insulin-like growth factor binding protein-3; insulin-like growth factor binding protein-4; insulin-like growth factor-1; intrauterine growth restriction; ischemic heart disease; left ventricle; nitric oxide; odds ratio; phosphatidyl-inositol-3-kinase; placental growth factor; preeclampsia; pregnancy; pregnancy-associated plasma protein-A; pregnancy-induced hypertension; renin angiotensin aldosterone system; sEng; sFlt-1; small for gestational age; soluble endoglin; soluble fms-like tyrosine kinase-1; standardised mean difference; stroke volume; sympathethic nervous system; systemic vascular resistances; transforming growth factor β; vascular endothelial growth factor.

Publication types

  • Review

MeSH terms

  • Animals
  • Disease Models, Animal
  • Female
  • Humans
  • Intercellular Signaling Peptides and Proteins / metabolism*
  • Neovascularization, Physiologic*
  • Pre-Eclampsia / metabolism*
  • Pre-Eclampsia / pathology
  • Pre-Eclampsia / physiopathology
  • Pregnancy
  • Risk Factors

Substances

  • Intercellular Signaling Peptides and Proteins