Soluble endoglin contributes to the pathogenesis of preeclampsia
Abstract
Preeclampsia is a pregnancy-specific hypertensive syndrome that causes substantial maternal and fetal morbidity and mortality. Maternal endothelial dysfunction mediated by excess placenta-derived soluble VEGF receptor 1 (sVEGFR1 or sFlt1) is emerging as a prominent component in disease pathogenesis. We report a novel placenta-derived soluble TGF-beta coreceptor, endoglin (sEng), which is elevated in the sera of preeclamptic individuals, correlates with disease severity and falls after delivery. sEng inhibits formation of capillary tubes in vitro and induces vascular permeability and hypertension in vivo. Its effects in pregnant rats are amplified by coadministration of sFlt1, leading to severe preeclampsia including the HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome and restriction of fetal growth. sEng impairs binding of TGF-beta1 to its receptors and downstream signaling including effects on activation of eNOS and vasodilation, suggesting that sEng leads to dysregulated TGF-beta signaling in the vasculature. Our results suggest that sEng may act in concert with sFlt1 to induce severe preeclampsia.
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Soluble endoglin is a cell surface co-receptor for transforming growth factor (TGF)-β1, which blocks TGF-β1-mediated activation of endothelial nitric oxide synthase (eNOS) and promotes vasorelaxation.
“Soluble endoglin is a cell surface co-receptor for transforming growth factor (TGF)-β1, which blocks TGF-β1–mediated activation of endothelial nitric oxide synthase (eNOS) and promotes vasorelaxation(124).”
From Metformin, the Aspirin of the 21st Century: Its Role in Gestational Diabetes Mellitus, Prevention of Preeclampsia and Cancer, and the Promotion of Longevity (2017) · cites this paper as [124]
If sVEGFR1 and soluble endoglin are given to pregnant rats, the animals develop preeclampsia, liver dysfunction, thrombocytopenia, and intrauterine growth restriction.
“Additionally, if sVEGFR1 and soluble endoglin are given to pregnant rats, the animals not only develop preeclampsia but also liver dysfunction, thrombocytopenia, and intrauterine growth restriction(124); similar results have been obtained in mice(141).”
From Metformin, the Aspirin of the 21st Century: Its Role in Gestational Diabetes Mellitus, Prevention of Preeclampsia and Cancer, and the Promotion of Longevity (2017) · cites this paper as [124]
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- Authors
- Venkatesha, S., Toporsian, M., Lam, C., Hanai, J.-I., Mammoto, T., Kim, Y. M., Bdolah, Y., Lim, K.-H., Yuan, H.-T., Libermann, T. A., Stillman, I. E., Roberts, D., D'Amore, P. A., Epstein, F. H., Sellke, F. W., Romero, R., Sukhatme, V. P., Letarte, M., & Karumanchi, S. A.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- University of Toronto (CA)
- National Institutes of Health (US)
- Harvard University (US)
- Corresponding author
- Karumanchi, S Ananth
- ORCID
- Venue
- Nature Medicine
- Published
- 2006-06-01
- Volume
- 12
- Issue
- 6
- Pages
- 642-649
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- OpenAlex
- W2105632053
- Cited by
- 1,855
- References
- 51
- Citations by year
- 2026: 45 · 2025: 48 · 2024: 49 · 2023: 68 · 2022: 88 · 2021: 106 · 2020: 80 · 2019: 88 · 2018: 99 · 2017: 113 · 2016: 92 · 2015: 97 · 2014: 102 · 2013: 101 · 2012: 130
- FWCI
- 126.42
- Type
- journal article
- Language
- en
- Update notices
- erratum (2006-07-01)
- Open access
- closed
- Locations
- Nature Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Heart and Stroke Foundation of Canada
- National Institutes of Health (1r03dk064255-01)
- National Heart, Lung, and Blood Institute (HL 079594, R01HL079594)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK064255)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › TGF-β signaling in diseases
- Keywords
- preeclampsia, soluble endoglin, soluble VEGF receptor-1, soluble fms-like tyrosine kinase-1, TGF-beta signaling, endothelial dysfunction, placenta, HELLP syndrome, fetal growth restriction, vascular permeability, hypertension, endothelial nitric oxide synthase, vasodilation, pathogenesis
- MeSH terms
- Endoglin, Adult, Amino Acid Sequence, Animals, Female, Gestational Age, Hemodynamics, Humans, Kidney, Liver, Middle Aged, Molecular Sequence Data, Placenta, Pre-Eclampsia, Pregnancy, Pregnancy, Animal, Receptors, Cell Surface, Signal Transduction, Antigens, CD, Transforming Growth Factor beta, Rats, Sprague-Dawley, Mice, Knockout, Vascular Endothelial Growth Factor Receptor-1, Endothelial Cells, Mice, Rats, Nitric Oxide Synthase Type III, Transforming Growth Factor beta1
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