What is the role of soluble endoglin (sEng) in the pathogenesis of preeclampsia?

Updated: Nov 29, 2018
  • Author: Kee-Hak Lim, MD; Chief Editor: Ronald M Ramus, MD  more...
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Answer

Answer

sEng is a soluble isoform of co-receptor for transforming growth factor beta (TGF-beta). Endoglin binds to TGF-beta in association with the TGF-beta receptor. Because the soluble isoform contains the TGF-beta binding domain, it can bind to circulating TGF-beta and decrease circulating levels. In addition, TGF-beta is a proangiogenic molecule, so the net effect of high levels of sEng is anti-angiogenic.

Several observations support the role of sEng in the pathogenesis of preeclampsia. It is found in the blood of women with preeclampsia up to 3 months before the clinical signs of the condition, its level in maternal blood correlates with disease severity, and the level of sEng in the blood drops after delivery. [33]

In studies on pregnant rats, administration of sEng results in vascular permeability and causes hypertension. There is also evidence that it has a synergistic relationship with sFlt-1, because it increases the effects of sFlt-1 in pregnant rats; this results in HELLP syndrome, as evidenced by hepatic necrosis, hemolysis, and placental infarction. [34] Moreover, sEng inhibits TGF-beta in endothelial cells and also inhibits TGF-beta-1 activation of nitric oxide mediated vasodilatation.


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