Day-2 SYMPOSIUM II: PREECLAMPSIA TREATMENTSSandra Blois | Brice Gaudillière | Sandra blois10:30-10:50- The prevention of preeclampsia with aspirin. Where are we? Vassilis TsatsarisAssistance Publique-Hôpital de Paris, Department of Obstetrics and Gynecology, Port-Royal Maternity, University Hospital Center Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, 53, Avenue de l'Observatoire, 75014, Paris, France; PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France ; PremU

• Published in: Journal of reproductive immunology Vol. 158; p. 103689
• Main Author: Lecarpentier, Edouard
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.08.2023
• ISSN: 0165-0378; 1872-7603
• DOI: 10.1016/j.jri.2022.103689

Preeclampsia is a hypertensive pregnancy disease associated with a massive increase in sFLT-1 in the maternal circulation, responsible for angiogenic imbalance and endothelial dysfunction. Pilot studies suggest that extracorporeal apheresis may reduce circulating sFLT-1 and prolong pregnancy. Non specific apheresis systems have potential adverse effects because of the capture of many other molecules. Our concept is based on a specific and competitive apheresis approach using VEGF (vascular endothelial growth factor) functionalized columns to capture sFLT-1 while releasing endogenous PlGF (placental growth factor) to restore a physiological angiogenic balance. Our previous works using magnetic beads functionalized with VEGF-A showed that in static conditions, sFLT-1 concentrations decreased by 33±13%, whereas PlGF concentrations increased by 27±10%. In dynamic conditions, the performances were improved, with 40% reduction of sFLT-1 and up to 2-fold increase of free PlGF. The sFLT-1/PlGF ratio was reduced by 63% in the plasma of preeclamptic patients. A ligand-based approach using VEGF-coated beads is an effective approach to the capture of sFLT-1 and the release of endogenous PlGF. This approach offers new perspectives for the treatment of preeclampsia.