Document Type : Original Research Article
Authors
1 Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
2 Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Jawa Timur, Indonesia
10.48309/ecc.2024.423519.1721
Abstract
Preeclampsia is identifiable by an imbalance of angiogenic factors, which entails elevated levels of sFlt-1 and a reduction of PlGF levels. In addition to disruptions in circadian rhythms, preeclamptic individuals may exhibit daytime and nighttime alterations in sFlt-1, PlGF, and the sFlt-1/PlGF ratio. This study aims to assess the differences in daytime and nighttime concentrations of sFlt-1, PlGF, and the sFlt-1/PlGF ratio in severe preeclamptic women between 30 and 34 weeks of gestational age. This cross-sectional study was conducted at Dr. Soetomo Public Academic Hospital and Airlangga University Hospital in Surabaya, involving ten pregnant women at 30-34 weeks of gestation, all diagnosed with severe preeclampsia. Samples of blood were drawn in the morning at 08:00, followed by the evening at 20:00. The study found no significant differences in serum levels of sFlt-1 (5.99 ± 3.29 vs. 6.82 ± 4.09 pg/mL), PlGF (85.5 [37-312] vs. 72 [35-437] pg/mL), and the sFlt-1/PlGF ratio (48.5 [6-233] vs. 58.5 [3-345] pg/mL) between day and night (p > 0.05). The results suggest that the circadian rhythm does not notably influence the serum levels of anti- and proangiogenic substances in confirmed severe preeclampsia.
Graphical Abstract
)
Keywords
Main Subjects
[1] (a) L. Say, D. Chou, A. Gemmill, Ö. Tunçalp, A. B. Moller, J. Daniels, A. M. Gülmezoglu, M. Temmerman, L. Alkema. Global causes of maternal death: a WHO systematic analysis, Lancet Glob. Health, 2014, 2, 323-333. [Crossref], [Google Scholar], [Publisher], (b) A. Sadek, R. Baban, M.F. Al-Habib, E.A. Khazaali, Assessment of serum afamin in patients with preeclampsia at third trimester, Journal of Medicinal and Pharmaceutical Chemistry Research, 2021, 3, 622-626. [Pdf], [Publisher]
[2] L.C. Poon, L.A. Magee, S. Verlohren, A. Shennan, P. von Dadelszen, E. Sheiner, E. Hadar, G. Visser, F. Da Silva Costa, A. Kapur, F. McAuliffe, A literature review and best practice advice for second and third trimester risk stratification, monitoring, and management of pre‐eclampsia: Compiled by the Pregnancy and Non‐Communicable Diseases Committee of FIGO (the International Federation of Gynecology and Obstetrics), Int J Gynaecol Obstet , 2021, 154, 3-31. [Crossref], [Google Scholar], [Publisher]
[3] L.A. Magee, M.A. Brown, D.R. Hall, S. Gupte, A. Hennessy, S.A. Karumanchi, L.C. Kenny, F. McCarthy, J. Myers, L.C. Poon, S. Rana, S. Saito, A.C. Staff, E. Tsigas, P. von Dadelszen, The 2021 international society for the study of hypertension in pregnancy classification, diagnosis & management recommendations for international practice, Pregnancy Hypertens, 2022, 27, 148-169. [Crossref], [Google Scholar], [Publisher]
[4] M.A. Brown, L.A. Magee, L.C. Kenny, S.A. Karumanchi, F.P. McCarthy, S. Saito, D.R. Hall, C.E. Warren, G. Adoyi, S. Ishaku, Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice, Hypertension, 2018, 72, 24-43. [Crossref], [Google Scholar], [Publisher]
[5] S. Rana, E. Lemoine, J. Granger, S.A. Karumanchi, Preeclampsia: pathophysiology, challenges, and perspectives. Circulation research, 2019, 124, 1094-1112. [Crossref], [Google Scholar], [Publisher]
[6] S. Agrawal, S. Shinar, A.S. Cerdeira, C. Redman, M. Vatish, Predictive performance of PlGF (Placental Growth Factor) for screening preeclampsia in asymptomatic women: a systematic review and meta-analysis, Hypertension, 2019, 74, 1124-1135. [Crossref], [GoogleScholar], [Publisher]
[7] E.A. Phipps, R. Thadhani, T. Benzing, S.A. Karumanchi, Preeclampsia: pathogenesis, novel diagnostics and therapies, Nat. Rev. Nephrol, 2019, 15, 275-289. [Crossref], [Google Scholar], [Publisher]
[8] A.C. Staff, The two-stage placental model of preeclampsia: An update, J. Reprod. Immunol, 2019, 134, 1-10. [Crossref], [Google Scholar], [Publisher]
[9] E. Jung, R. Romero, L. Yeo, N. Gomez-Lopez, P. Chaemsaithong, A. Jaovisidha, F. Gotsch O. Erez, The etiology of preeclampsia, Am J Obstet Gynecol, 2022, 226, 844-866. [Crossref], [Google Scholar], [Publisher]
[10] X. Bian, A. Biswas, X. Huang, K.J. Lee, T.K. Li, H. Masuyama, A. Ohkuchi, J.S. Park, S. Saito, K.H. Tan, T. Yamamoto, Short-term prediction of adverse outcomes using the sFlt-1 (soluble fms-Like tyrosine kinase 1)/PlGF (placental growth factor) ratio in Asian women with suspected preeclampsia, Hypertension, 2019, 74, 164-172. [Crossref], [Google Scholar], [Publisher]
[11] S. Rowson, M. Reddy, D.L. De Guingand, A. Langston-Cox, S.A. Marshall, F. da Silva Costa, K.R. Palmer, Comparison of circulating total sFLT-1 to placental-specific sFLT-1 e15a in womenwith suspected preeclampsia. Placenta, 2022, 120, 73-78. [Crossref], [Google Scholar], [Publisher]
[12] S. Verlohren, S.P. Brennecke, A. Galindo, S.A. Karumanchi, L.B. Mirkovic, D. Schlembach, H. Stepan, M. Vatish, H. Zeisler, S. Rana, Clinical interpretation and implementation of the sFlt-1/PlGF ratio in the prediction, diagnosis and management of preeclampsia, Pregnancy Hypertension, 2022, 27, 42-50. [Crossref], [Google Scholar], [Publisher]
[13] H. Stepan, A. Galindo, M. Hund, D. Schlembach, J. Sillman, D. Surbek, M. Vatish, Clinical utility of sFlt-1 and PlGF in screening,prediction, diagnosis and monitoring of preeclampsia and fetal growth restriction, Ultrasound in Obstetrics & Gynecology, 2023, 61, 168-180. [Crossref], [Google Scholar], [Publisher]
[14] L.A. Magee, K.H. Nicolaides, P. von Dadelszen, Preeclampsia, N Engl J Med, 2022, 386, 1817-1832. [Crossref], [Google Scholar], [Publisher]
[15] S. Rana, S.D. Burke, S.A. Karumanchi, Imbalances in circulating angiogenic factors in the pathophysiology of preeclampsia and related disorders, Am J Obstet Gynecol, 2022, 226, 1019-1034. [Crossref], [Google Scholar], [Publisher]
[16] T. Yamazaki, A.S. Cerdeira, S. Agrawal, I. Koh, J. Sugimoto, M. Vatish, Y. Kudo, Predictive accuracy of soluble FMS-like tyrosine kinase-1/placental growth factor ratio for preeclampsia in Japan: A systematic review, Hypertension Research in Pregnancy, 2021, 9, 1-7. [Crossref], [Google Scholar], [Publisher]
[17] A. Umapathy, L.W. Chamley, J.L. James, Reconciling the distinct roles of angiogenic/anti-angiogenic factors in the placenta and maternal circulation of normal and pathological pregnancies, Angiogenesis, 2020, 23, 105-117. [Crossref], [Google Scholar], [Publisher]
[18] R. Verteramo, M. Pierdomenico, P. Greco C. Milano, The role of melatonin in pregnancy and the health benefits for the Newborn, Biomedicines, 2022, 10, 3252. [Crossref], [Google Scholar], [Publisher]
[19] I. Fantasia, S. Bussolaro, T. Stampalija, D. L. Rolnik. The role of melatonin in pregnancies complicated by placental insufficiency: A systematic review, European Journal of Obstetrics & Gynecology and Reproductive Biology, 2022, 278, 22-28. [Crossref], [Google Scholar], [Publisher]
[20] A. Langston-Cox, S. A. Marshall, D. Lu, K. R. Palmer, E.M. Wallace, Melatonin for the management of preeclampsia: A review, Antioxidants, 2021, 10, 376. [Crossref], [Google Scholar], [Publisher]
[21] N.A.S. Mohd Azmi, N. Juliana, S. Azmani, N. Mohd Effendy, I.F. Abu, N.I. Mohd Fahmi Teng S. Das, Cortisol on circadian rhythm and its effect on cardiovascular system, International Journal of Environmental Research and Public Health, 2021, 18, 676 [Crossref], [Google Scholar], [Publisher]
[22] A. Ditisheim, C. Dibner, J. Philippe, A. Pechère-Bertschi, Biological rhythms and preeclampsia, Frontiers in Endocrinology, 2013, 4, 1-8, Review. [Crossref], [Google Scholar], [Publisher]
[23] S. Bouchlariotou, V. Liakopoulos, M. Giannopoulou, S. Arampatzis, T. Eleftheriadis, P.R. Mertens, E. Zintzaras, I.E. Messinis, I. Stefanidis, Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm, Renal Failure, 2014, 36, 1001-1007. [Crossref], [Google Scholar], [Publisher]
[24] M.E. Aml, The interaction between maternal and fetal hypothalamic – pituitary – adrenal axes, Corticosteroids, P. Celso Ed.; IntechOpen, 2021, 1-12. [Crossref]
[25] L. Saleh, A.H. van den Meiracker, R. Geensen, A. Kaya, J.E. Roeters van Lennep, J.J. Duvekot, K. Verdonk, E.A.P. Steegers, H. Russcher, A.H.J. Danser, Soluble fms-like tyrosine kinase-1 and placental growth factor kinetics during and after pregnancy in women with suspected or confirmed preeclampsia, Ultrasound in Obstetrics & Gynecology, 2018, 51, 751-757. [Crossref], [Google Scholar], [Publisher]
[26] S. Rana, S. Salahuddin, A. Mueller, A.H. Berg, R.I. Thadhani, S.A. Karumanchi, Angiogenic biomarkers in triage and risk for preeclampsia with severe features, Pregnancy Hypertension, 2018, 13, 100-106. [Crossref], [Google Scholar], [Publisher]
[27] M.H. Bublitz, G. Bourjeily, C. D’Angelo, L. R. Stroud, Maternal sleep quality and diurnal cortisol regulation over pregnancy, Behavioral Sleep Medicine, 2018, 13, 100-106. [Crossref], [Google Scholar], [Publisher]
[28] Roche Diagnostics, Elecsys sFlt-1; Roche Diagnostics GmbH, 2018 [Publisher]
[29] Roche Diagnostics, Elecsys PlGF Roche Diagnostics GmbH, 2022. [Publisher]
[30] J. Huart, A. Persu, J.P. Lengelé, J.M. Krzesinski, F. Jouret, G.S. Stergiou, Pathophysiology of the nondipping blood pressure pattern, Hypertension, 2023, 80, 719-729. [Crossref], [Google Scholar], [Publisher]
[31] V. Pergialiotis, N. Karampetsou, I. Bellos, N. Papantoniou, G. Daskalakis. Nocturnal blood pressure alterations in patients with preeclampsia- Do they really matter? A systematic review of the literature. European Journal of Obstetrics and Gynecology and Reproductive Biology, 2019, 239, 39-44. [Crossref], [Google Scholar], [Publisher]
[32] A. B. Diallo, B. Coiffard, R. Desbriere, M. Katsogiannou, X. Donato, F. Bretelle, S. Mezouar, J.L. Mege, Disruption of the expression of the placental clock and melatonin genes in preeclampsia, International Journal of Molecular Sciences, 2023, 24, 2363 [Crossref], [Google Scholar], [Publisher]
[33] K. Bates, E.D. Herzog, Maternal-fetal circadian communication during pregnancy, Frontiers in Endocrinology, 2020, 11, 1-9, Review. [Crossref], [Google Scholar], [Publisher]
[34] K. Kosicka, A. Siemiątkowska, A. Szpera-Goździewicz, M. Krzyścin, G.H. Bręborowicz, F.K. Główka, Increased cortisol metabolism in women with pregnancy-related hypertension, Endocrine, 2018, 61, 125-133. [Crossref], [Google Scholar], [Publisher]
[35] T.G.R. Húngaro, M.F. Gregnani, T. Alves-Silva, F. Herse, N. Alenina, M. Bader, R.C. Araújo, Cortisol dose-dependently impairs migration and tube-like formation in a trophoblast cell line and modulates inflammatory and angiogenic genes, Biomedicines, 2021, 9, 980. [Crossref], [Google Scholar], [Publisher]
[36] S. Chan, M. Debono, Review: replication of cortisol circadian rhythm: new advances in hydrocortisone replacement therapy, Therapeutic Advances in Endocrinology and Metabolism, 2010, 1, 129-138. [Crossref], [Google Scholar], [Publisher]
[37] G. Wang, Y. Huang, T. Hu, B. Zhang, Z. Tang, R. Yao, Y. Huang, X. Fan, X. Ni. Contribution of placental 11β-HSD2 to the pathogenesis of preeclampsia, The FASEB Journal, 2020, 34, 15379-15399. [Crossref], [Google Scholar], [Publisher]
[38] K. Kosicka-Noworzyń, A. Siemiątkowska, F. Główka, 11βHydroxysteroid dehydrogenase 2 in preeclampsia, International Journal of Endocrinology, 2016, 2016, 1-9. [Crossref], [Google Scholar], [Publisher]
[39] F.J. Valenzuela-Melgarejo, C. Lagunas, F. Carmona-Pastén, K. Jara-Medina, G. Delgado, Supraphysiological role of melatonin over vascular dysfunction of pregnancy, a new therapeutic agent? Frontiers in Physiology, 2021, 12 , 1-13. [Crossref], [Google Scholar], [Publisher]
[40] Y. Tang, K. Groom, L. Chamley, Q. Chen, Melatonin, a potential therapeutic agent for preeclampsia, reduces the extrusion of toxic extracellular vesicles from preeclamptic placentae, Cells, 2021, 10, 1904. [Crossref], [Google Scholar], [Publisher]
[41] R. McCarthy, E.S. Jungheim, J.C. Fay, K. Bates, E.D. Herzog, S.K. England, Riding the rhythm of melatonin through pregnancy to deliver on time, Frontiers in Endocrinology, 2019, 10, 1-11, Review. [Crossref], [Google Scholar], [Publisher]
[42] M. Miyata, M. Ohishi, Novel strategies for the management of nocturnal hypertension, Circulation Journal, 2017, 81, 938-939. [Crossref], [Google Scholar], [Publisher]
[43] K.E. Duhig, J.E. Myers, C. Gale, J.C. Girling, K. Harding, A. Sharp, N.A.B. simpson, D. Tuffnell, P.T. Seed, A.H. Shennan, Placental growth factor measurements in the assessment of women with suspected Preeclampsia: A stratified analysis of the PARROT trial, Pregnancy Hypertension, 2021, 23, 41-47. [Crossref], [Google Scholar], [Publisher]
[44] S. Hoshide, Nocturnal hyperten sionsolving the puzzle of preeclampsia risk, Hypertension Research, 2021, 44, 1681-1682. [Crossref], [Google Scholar], [Publisher]
[45] J. Baker, K. Kimpinski. Role of melatonin in blood pressure regulation: An adjunct anti-hypertensive agent, Clinical and Experimental Pharmacology and Physiology, 2018, 45, 755-766. [Crossref], [Google Scholar], [Publisher]
)