Twin-to-twin transfusion syndrome: an antiangiogenic state?

Juan Pedro Kusanovic, Roberto Romero, Jimmy Espinoza, Jyh Kae Nien, Chong Jai Kim, Pooja Mittal, Sam Edwin, Offer Erez, Francesca Gotsch, Shali Mazaki-Tovi, Nandor G. Than, Eleazar Soto, Natalia Camacho, Ricardo Gomez, Ruben Quintero, Sonia S. Hassan

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Objective: An imbalanced chronic blood flow between the donor and recipient twin through placental vascular anastomoses is the accepted pathophysiology of twin-to-twin transfusion syndrome (TTTS). Vascular endothelial growth factor receptor-1 (VEGFR-1) mRNA is overexpressed only in the syncytiotrophoblast of the donor twin in some cases of TTTS. This study was conducted to determine maternal plasma concentrations of placental growth factor (PlGF), soluble VEGFR-1, and soluble endoglin (s-Eng) in monochorionic-diamniotic pregnancies with and without TTTS. Study Design: This case-control study included monochorionic-diamniotic pregnancies between 16-26 weeks with and without TTTS. Maternal plasma concentrations of PlGF, sVEGFR-1, and s-Eng were determined with ELISA. A P value < .05 was considered statistically significant. Results: Patients with TTTS had higher median plasma concentrations of s-Eng (14.8 ng/mL vs 7.8 ng/mL; P < .001) and sVEGFR-1 (6383.1 pg/mL vs 3220.1 pg/mL; P < .001]; and lower median plasma concentrations of PlGF (115.5 pg/mL vs 359.3 pg/mL; P = .002) than those without TTTS. Conclusion: We propose that an antiangiogenic state may be present in some cases of TTTS.

Original languageEnglish
JournalAmerican Journal of Obstetrics and Gynecology
Volume198
Issue number4
DOIs
StatePublished - Apr 1 2008

Fingerprint

Fetofetal Transfusion
Vascular Endothelial Growth Factor Receptor-1
Intercellular Signaling Peptides and Proteins
Mothers
Tissue Donors
Pregnancy
Trophoblasts
Blood Vessels
Case-Control Studies
Enzyme-Linked Immunosorbent Assay
Messenger RNA

Keywords

  • angiogenesis
  • angiogenic factors
  • birthweight discordancy
  • endoglin
  • monochorionic
  • placental growth factor
  • PlGF
  • sFlt1
  • sVEGFR-1
  • TTTS
  • twin pregnancy

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Kusanovic, J. P., Romero, R., Espinoza, J., Nien, J. K., Kim, C. J., Mittal, P., ... Hassan, S. S. (2008). Twin-to-twin transfusion syndrome: an antiangiogenic state? American Journal of Obstetrics and Gynecology, 198(4). https://doi.org/10.1016/j.ajog.2008.02.016

Twin-to-twin transfusion syndrome : an antiangiogenic state? / Kusanovic, Juan Pedro; Romero, Roberto; Espinoza, Jimmy; Nien, Jyh Kae; Kim, Chong Jai; Mittal, Pooja; Edwin, Sam; Erez, Offer; Gotsch, Francesca; Mazaki-Tovi, Shali; Than, Nandor G.; Soto, Eleazar; Camacho, Natalia; Gomez, Ricardo; Quintero, Ruben; Hassan, Sonia S.

In: American Journal of Obstetrics and Gynecology, Vol. 198, No. 4, 01.04.2008.

Research output: Contribution to journalArticle

Kusanovic, JP, Romero, R, Espinoza, J, Nien, JK, Kim, CJ, Mittal, P, Edwin, S, Erez, O, Gotsch, F, Mazaki-Tovi, S, Than, NG, Soto, E, Camacho, N, Gomez, R, Quintero, R & Hassan, SS 2008, 'Twin-to-twin transfusion syndrome: an antiangiogenic state?', American Journal of Obstetrics and Gynecology, vol. 198, no. 4. https://doi.org/10.1016/j.ajog.2008.02.016
Kusanovic, Juan Pedro ; Romero, Roberto ; Espinoza, Jimmy ; Nien, Jyh Kae ; Kim, Chong Jai ; Mittal, Pooja ; Edwin, Sam ; Erez, Offer ; Gotsch, Francesca ; Mazaki-Tovi, Shali ; Than, Nandor G. ; Soto, Eleazar ; Camacho, Natalia ; Gomez, Ricardo ; Quintero, Ruben ; Hassan, Sonia S. / Twin-to-twin transfusion syndrome : an antiangiogenic state?. In: American Journal of Obstetrics and Gynecology. 2008 ; Vol. 198, No. 4.
@article{5292baa34e2241edb0dff898c1d458e6,
title = "Twin-to-twin transfusion syndrome: an antiangiogenic state?",
abstract = "Objective: An imbalanced chronic blood flow between the donor and recipient twin through placental vascular anastomoses is the accepted pathophysiology of twin-to-twin transfusion syndrome (TTTS). Vascular endothelial growth factor receptor-1 (VEGFR-1) mRNA is overexpressed only in the syncytiotrophoblast of the donor twin in some cases of TTTS. This study was conducted to determine maternal plasma concentrations of placental growth factor (PlGF), soluble VEGFR-1, and soluble endoglin (s-Eng) in monochorionic-diamniotic pregnancies with and without TTTS. Study Design: This case-control study included monochorionic-diamniotic pregnancies between 16-26 weeks with and without TTTS. Maternal plasma concentrations of PlGF, sVEGFR-1, and s-Eng were determined with ELISA. A P value < .05 was considered statistically significant. Results: Patients with TTTS had higher median plasma concentrations of s-Eng (14.8 ng/mL vs 7.8 ng/mL; P < .001) and sVEGFR-1 (6383.1 pg/mL vs 3220.1 pg/mL; P < .001]; and lower median plasma concentrations of PlGF (115.5 pg/mL vs 359.3 pg/mL; P = .002) than those without TTTS. Conclusion: We propose that an antiangiogenic state may be present in some cases of TTTS.",
keywords = "angiogenesis, angiogenic factors, birthweight discordancy, endoglin, monochorionic, placental growth factor, PlGF, sFlt1, sVEGFR-1, TTTS, twin pregnancy",
author = "Kusanovic, {Juan Pedro} and Roberto Romero and Jimmy Espinoza and Nien, {Jyh Kae} and Kim, {Chong Jai} and Pooja Mittal and Sam Edwin and Offer Erez and Francesca Gotsch and Shali Mazaki-Tovi and Than, {Nandor G.} and Eleazar Soto and Natalia Camacho and Ricardo Gomez and Ruben Quintero and Hassan, {Sonia S.}",
year = "2008",
month = "4",
day = "1",
doi = "10.1016/j.ajog.2008.02.016",
language = "English",
volume = "198",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Twin-to-twin transfusion syndrome

T2 - an antiangiogenic state?

AU - Kusanovic, Juan Pedro

AU - Romero, Roberto

AU - Espinoza, Jimmy

AU - Nien, Jyh Kae

AU - Kim, Chong Jai

AU - Mittal, Pooja

AU - Edwin, Sam

AU - Erez, Offer

AU - Gotsch, Francesca

AU - Mazaki-Tovi, Shali

AU - Than, Nandor G.

AU - Soto, Eleazar

AU - Camacho, Natalia

AU - Gomez, Ricardo

AU - Quintero, Ruben

AU - Hassan, Sonia S.

PY - 2008/4/1

Y1 - 2008/4/1

N2 - Objective: An imbalanced chronic blood flow between the donor and recipient twin through placental vascular anastomoses is the accepted pathophysiology of twin-to-twin transfusion syndrome (TTTS). Vascular endothelial growth factor receptor-1 (VEGFR-1) mRNA is overexpressed only in the syncytiotrophoblast of the donor twin in some cases of TTTS. This study was conducted to determine maternal plasma concentrations of placental growth factor (PlGF), soluble VEGFR-1, and soluble endoglin (s-Eng) in monochorionic-diamniotic pregnancies with and without TTTS. Study Design: This case-control study included monochorionic-diamniotic pregnancies between 16-26 weeks with and without TTTS. Maternal plasma concentrations of PlGF, sVEGFR-1, and s-Eng were determined with ELISA. A P value < .05 was considered statistically significant. Results: Patients with TTTS had higher median plasma concentrations of s-Eng (14.8 ng/mL vs 7.8 ng/mL; P < .001) and sVEGFR-1 (6383.1 pg/mL vs 3220.1 pg/mL; P < .001]; and lower median plasma concentrations of PlGF (115.5 pg/mL vs 359.3 pg/mL; P = .002) than those without TTTS. Conclusion: We propose that an antiangiogenic state may be present in some cases of TTTS.

AB - Objective: An imbalanced chronic blood flow between the donor and recipient twin through placental vascular anastomoses is the accepted pathophysiology of twin-to-twin transfusion syndrome (TTTS). Vascular endothelial growth factor receptor-1 (VEGFR-1) mRNA is overexpressed only in the syncytiotrophoblast of the donor twin in some cases of TTTS. This study was conducted to determine maternal plasma concentrations of placental growth factor (PlGF), soluble VEGFR-1, and soluble endoglin (s-Eng) in monochorionic-diamniotic pregnancies with and without TTTS. Study Design: This case-control study included monochorionic-diamniotic pregnancies between 16-26 weeks with and without TTTS. Maternal plasma concentrations of PlGF, sVEGFR-1, and s-Eng were determined with ELISA. A P value < .05 was considered statistically significant. Results: Patients with TTTS had higher median plasma concentrations of s-Eng (14.8 ng/mL vs 7.8 ng/mL; P < .001) and sVEGFR-1 (6383.1 pg/mL vs 3220.1 pg/mL; P < .001]; and lower median plasma concentrations of PlGF (115.5 pg/mL vs 359.3 pg/mL; P = .002) than those without TTTS. Conclusion: We propose that an antiangiogenic state may be present in some cases of TTTS.

KW - angiogenesis

KW - angiogenic factors

KW - birthweight discordancy

KW - endoglin

KW - monochorionic

KW - placental growth factor

KW - PlGF

KW - sFlt1

KW - sVEGFR-1

KW - TTTS

KW - twin pregnancy

UR - http://www.scopus.com/inward/record.url?scp=41349106757&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=41349106757&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2008.02.016

DO - 10.1016/j.ajog.2008.02.016

M3 - Article

C2 - 18395032

AN - SCOPUS:41349106757

VL - 198

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 4

ER -