Ангиогенные и антиангиогенные факторы в генезе аномалий плацентации

Цель обзора. Оценить роль плацентарного фактора роста (placenta growth factor, PlGF), васкуло-эндотелиального фактора роста (vascular endothelial growth factor, VEGF), растворимой fms-подобной тирозинкиназы 1 (soluble fms-like tyrosine kinase-1, sFlt-1) в патогенезе плацентарной адгезивно-инвазивной патологии (ПАИП).

Основные положения. sFlt-1 является ингибитором ангиогенного действия PlGF и VEGF. Ее концентрация в сыворотке крови пациенток с ПАИП была значимо ниже, чем у женщин с физиологической беременностью во всех исследованиях, представленных в данном обзоре. Только в двух исследованиях определены пороговые значения для сывороточных маркеров при ПАИП, но, по результатам метаанализа, они сильно различались. Несмотря на известную проангиогенную функцию VEGF и PlGF, значимая корреляция между их уровнями не найдена ни в сыворотке крови методом иммуноферментного анализа, ни в экспрессии на клетках хориона, децидуальной ткани и миометрия при аномальной инвазии плаценты.

Заключение. Необходимо дальнейшее изучение роли VEFG, PlGF и sFlt-1 в патогенезе ПАИП для поиска их пороговых уровней в крови и использования в качестве диагностических маркеров.

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