Acute Pyelonephritis during Pregnancy Changes the Balance of Angiogenic and Anti-Angiogenic Factors in Maternal Plasma

摘要

ObjectiveAngiogenic factors have been implicated in the pathophysiology of sepsis. In experimental models of sepsis (endotoxemia and/or cecal ligation puncture), there is increased expression of vascular endothelial growth factors (VEGF) and the administration of exogenous soluble VEGF receptor (sVEGFR)-1, an antagonist to VEGF, reduces morbidity and mortality. Moreover, a dramatic elevation in sVEGFR-1 has been demonstrated in human sepsis. Although a balance between angiogenic and anti-angiogenic factors is essential for feto-placental development, the changes of angiogenic factors during pregnancy in the context of infection have never been explored. Angiogenic factors also play crucial roles in the pathophysiology of preeclampsia. This study was conducted to determine if maternal plasma concentrations of placental growth factor (PlGF), sVEGFR-2 and soluble endoglin (sEng) change in pregnancies complicated by acute pyelonephritis (AP) compared to normal pregnancy and preeclampsia (PE).