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Article: Holger Stepan, Thomas Krämer, and Renaldo Faber Maternal plasma concentrations of soluble endoglin in pregnancies with intrauterine growth restriction J Clin Endocrinol Metab 2007; 0: jc.2006-2774v1 [Abstract]

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On the edge

Alexandre Hertig, Eric Rondeau, Guillaume Lefevre, Nadia Berkane   (13 June 2007)

On the edge 13 June 2007
Alexandre Hertig, Clinical Assistant Renal ICU, Hôpital Tenon, Paris, Eric Rondeau, Guillaume Lefevre, Nadia Berkane Send letter to journal: Re: On the edge alexandre.hertig{at}tnn.aphp.fr Alexandre Hertig, et al.	In their interesting study on intra-uterine growth retardation, Stepan et al. (1) have demonstrated that placental insufficiency may gradually alter maternal vessels: a mild increase in angiogenic factors would leave the mother safe from hypertension and glomerular endotheliosis, while a major increase would induce typical preeclampsia. The data reported by Masuyama et al. (2) further support a dose-dependent effect, since among preeclamptic patients, the blood pressure is all the more increased for high serum endoglin/sFlt1 concentrations. Information on this dose-effect relationship is crucial and gives some credit to the hypothesis (so far optimistic) that the maternal symptoms of preeclampsia could soon be targeted and monitored on the basis of a diagnostic biomarker. In this regard, it would have been interesting, in both studies, to know whether microalbuminuria is correlated or not to this gradual increase in angiogenic factors. As in many cardiovascular adult diseases, "old and cheap" albuminuria could be the visible part of the iceberg during placenta-related maternal disorders. References 1. Stepan H, Krämer T, Faber R. 2007. Maternal plasma concentrations of soluble endoglin in pregnancies with intrauterine growth restriction. J Clin Endocrinol Metab doi:10.1210/jc.2006-2774, published online April 10, 2007 2. Masuyama H, Nakatsukasa H, Takamoto N, Hiramatsu A. 2007. Correlation between soluble endoglin, vascular endothelial growth factor receptor-1 and adipocytokines in preeclampsia. J Clin Endocrinol Metab doi:10.1210/jc.2006-2349, published online April 10, 2007