TY - JOUR
T1 - The impact of laser surgery on angiogenic and anti-angiogenic factors in twin–twin transfusion syndrome
T2 - a prospective study*
AU - Chon, Andrew H.
AU - Chavira, Emiliano R.
AU - Wilson, Melissa L.
AU - Ingles, Sue A.
AU - Llanes, Arlyn
AU - Chmait, Ramen H.
N1 - Publisher Copyright:
© 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/4/18
Y1 - 2018/4/18
N2 - Objective: To examine the effect of laser surgery on angiogenic and anti-angiogenic factors in patients with twin–twin transfusion syndrome (TTTS). Methods: Cases of TTTS and uncomplicated monochorionic diamniotic twin pregnancies between 16 and 26 weeks’ gestation were prospectively enrolled into the study. Maternal blood samples were obtained to measure angiogenic factors (vascular endothelial growth factor-A [VEGF], placental-derived growth factor [PlGF], and endothelin) and anti-angiogenic factors (soluble fms-like tyrosine kinase (sFlt-1), soluble endoglin (sEng), and sFlt-1/PlGF ratio). For cases, these factors were measured at visit 1 (pre-operatively), visit 2 (postoperative day one), and visit 3 (at least 3 weeks after surgery). In controls, the factors were measured at visit 1 (enrollment) and visit 2 (at least 3 weeks later). Levels of angiogenic and anti-angiogenic factors between cases and controls were compared. Results: At enrollment, the TTTS cases demonstrated an anti-angiogenic state with significantly higher sFlt-1, sEng, sFlt-1/PlGF ratio, and lower PlGF. Laser surgery, comparing visit 1–3, had a partial corrective effect on TTTS cases. sFlt-1 significantly decreased several weeks after surgery. The other factors (PlGF, endothelin, sFlt-1, sEng, and sFlt-1/PlGF ratio) were not statistically significantly different by visit 3. Conclusion: Laser surgery partially corrected the angiogenic profile in patients with TTTS.
AB - Objective: To examine the effect of laser surgery on angiogenic and anti-angiogenic factors in patients with twin–twin transfusion syndrome (TTTS). Methods: Cases of TTTS and uncomplicated monochorionic diamniotic twin pregnancies between 16 and 26 weeks’ gestation were prospectively enrolled into the study. Maternal blood samples were obtained to measure angiogenic factors (vascular endothelial growth factor-A [VEGF], placental-derived growth factor [PlGF], and endothelin) and anti-angiogenic factors (soluble fms-like tyrosine kinase (sFlt-1), soluble endoglin (sEng), and sFlt-1/PlGF ratio). For cases, these factors were measured at visit 1 (pre-operatively), visit 2 (postoperative day one), and visit 3 (at least 3 weeks after surgery). In controls, the factors were measured at visit 1 (enrollment) and visit 2 (at least 3 weeks later). Levels of angiogenic and anti-angiogenic factors between cases and controls were compared. Results: At enrollment, the TTTS cases demonstrated an anti-angiogenic state with significantly higher sFlt-1, sEng, sFlt-1/PlGF ratio, and lower PlGF. Laser surgery, comparing visit 1–3, had a partial corrective effect on TTTS cases. sFlt-1 significantly decreased several weeks after surgery. The other factors (PlGF, endothelin, sFlt-1, sEng, and sFlt-1/PlGF ratio) were not statistically significantly different by visit 3. Conclusion: Laser surgery partially corrected the angiogenic profile in patients with TTTS.
KW - Angiogenesis
KW - VEGF
KW - twin–twin transfusion syndrome
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U2 - 10.1080/14767058.2017.1309020
DO - 10.1080/14767058.2017.1309020
M3 - Article
C2 - 28320252
AN - SCOPUS:85017154473
SN - 1476-7058
VL - 31
SP - 1085
EP - 1091
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 8
ER -