Preeclampsia is an important disease during pregnancy and causes significant maternal and fetal mortality and morbidity. Despite intense research efforts, the etiology and pathogenesis of the disease remain largely unknown. Since placentas from preeclamptic patients are smaller than normal, and cytokine growth factors are suggested to be important in placental growth, the effects of macrophage-colony stimulating factor (M-CSF) on human trophoblast cells were examined. While term trophoblast cells did not respond to M-CSF, those from early trimester and choriocarcinoma cells showed enhanced growth after treatment. In addition, the serum level of M-CSF in hypertensive pregnant women at the second trimester were significantly lower than those of normal pregnant women. These data suggest possible roles of M-CSF in preeclampsia. When M-CSF was administered to pregnant rats on days 8-11, rats had smaller placentas at day 12 and increased fetal resorption rate at day 20. The effects of interleukin-12 (IL-12) was also examined on days 8-11. While placental development was normal at both days 12 and 20, fetuses were significantly smaller at day 20. To remedy the difficulties and dangers associated with obtaining human placentas, I characterized endovascular trophoblast cell behavior in pregnant rats. In normal pregnancy, rat trophoblast cells simulated all features of human endovascular trophoblast behavior including selective invasion into the spiral arteries, retrograde migration, embedding, and secretion of PAS-positive materials as well as IIphysiological changes," In pregnancy terminated with a certain type of spontaneous fetal resorption, defective endovascular trophoblast cell behavior was observed, which was similar to that reported in preeclamptic pregnancy. Finally, the roles of cytoskeleton on trophoblast cell locomotion were investigated in vivo with a cytoskeleton-disrupting agent, cytochalasin B. This treatment impaired trophoblast cell invasion at day 12 and induced smaller fetuses at day 20, suggesting the importance of cytoskeleton in trophoblast movement. In conclusion, the results suggest the importance of the use of appropriate specimens and endpoints in the study of pregnancy, and rats may serve as a suitable animal model for the study of endovascular trophoblast cell behavior with clinical relevance to preeclampsia. / Ph. D.

Hypertensive disorders of pregnancy affect approximately 8% of pregnancies, and can lead to serious complications for both mother and child. While Latinas are at two-fold increased risk of preeclampsia relative to non-Latina white women, little research on hypertension in pregnancy has been conducted in this population. Furthermore, there are few modifiable risk factors for hypertensive pregnancy. Therefore, we examined associations between psychosocial stress, physical activity, and pre-pregnancy BMI and gestational weight gain and hypertensive disorders of pregnancy using data from the Latina GDM Study, a prospective cohort study of 1,231 women. The first study evaluated the association between perceived stress in early pregnancy and hypertensive disorders of pregnancy. Prior studies suggest an increased risk of hypertensive pregnancy associated with high levels of work-related stress, however there is no previous research evaluating the impact of general psychosocial stress. Psychosocial stress was measured in early pregnancy through the Perceived Stress Scale and hypertensive disorders of pregnancy were confirmed through obstetrician review of medical records. Using multivariable logistic regression we found no statistically significant association between early pregnancy stress and hypertensive pregnancy. The second study focused on the association between pre- and early pregnancy physical activity and hypertensive pregnancy. While some prior literature suggests that pre- and early pregnancy physical activity may be inversely associated with hypertensive pregnancy, findings are not conclusive. Pre- and early pregnancy physical activity was quantified using the Kaiser Physical Activity Survey, administered early in pregnancy. In this study, there was no statistically significant association between pre-pregnancy physical activity and hypertensive pregnancy. However, early pregnancy physical activity (total and household/caregiving) was inversely associated with risk of gestational hypertension. Finally, we examined the associations between pre-pregnancy BMI and gestational weight gain and hypertensive pregnancy. Previous studies in this area have included few Latinas. We found an increase in risk of hypertensive disorders with increased pre-pregnancy BMI and gestational weight gain exceeding the current Institute of Medicine guidelines for weight gain in pregnancy. These findings extend prior research to a Latina population. In summary, this dissertation research adds to the limited research on modifiable risk factors for hypertensive disorders of pregnancy.

Current research spans a wide range of objectives whose diversity includes the understanding of global epidemiology and the detailing of molecular interactions leading to specific pathologies. This work aligns more closely with the goal of mechanistic clarity by elucidating several aspects of signaling pathways involved in inflammatory and obstetric pathologies. Prior research has confirmed the role of Receptors for Advanced Glycation End-Products (RAGE) activation in signaling leading to chronic inflammation such as that observed in chronic obstructive pulmonary disease (COPD). RAGE activation has also been identified in other disease states including diabetes, Alzheimer’s disease, osteoarthritis, and cancers. We examined the role of RAGE in the obstetric complication intrauterine growth restriction (IUGR) wherein fetal development is delayed and infants are born at low birthweight. Exposure to tobacco smoke is known to activate RAGE, and smoke exposure also increases risk for IUGR. We confirm a role for RAGE signaling in development of IUGR. RAGE inhibition by semi-synthetic glycosaminoglycan ethers (SAGEs) significantly improved fetal and placental weights and reduced inflammatory signaling molecules. Interactions between RAGE and other signaling pathways have been noted in several research endeavors, and we sought to further understand signaling interactions specifically in obstetric pathologies by examining relationships between RAGE and Gas6/AXL signaling. We confirm that RAGE and Gas6/AXL signaling are not independent. Using tobacco smoke as a means of inducing RAGE, we determined that total AXL is inhibited when RAGE is active, but that phosphorylated AXL is increased. Inhibition of RAGE also increased Gas6 expression. These interactions require further clarification, but provide a foundation to expand upon. We further studied interactions within the Gas6/AXL pathway independent of RAGE. High levels of Gas6 have been noted in the serum of some women with preeclampsia, and early diagnosis and treatment of preeclampsia are currently limited. We demonstrate that, in a rat model, administration of Gas6 during pregnancy is sufficient to induce symptoms of preeclampsia including high blood pressure, increased proteinuria, and decreased trophoblast invasion. This provides a novel model which will further both diagnosis and treatment of preeclampsia. We also demonstrated that trophoblast invasion is influenced in a cell-type dependent manner by Gas6 and mTOR signaling, with decreased trophoblast invasion when Gas6 is high in trophoblast cells, but increased invasion with high Gas6 in a pulmonary adenocarcinoma cell type and in oral squamous cell carcinoma cells. Our work has clarified details of both RAGE and Gas6/AXL signaling that are crucial to further study of the pathways in which they are active, and the pathologies resulting from signaling misregulation.

No description available.

OBJECTIF: Évaluer si la prééclampsie (PE) récidivante présente un taux de prématurité (< 37 semaines de gestation) plus élevé qu'une première PE. Les critères de jugement secondaires étaient le retard de croissance intra-utérin (RCIU) et la morbidité maternelle. MÉTHODES: Il s'agit d'une étude rétrospective de cohorte conduite sur 383 femmes avec un diagnostic de prééclampsie et ayant accouché au CHU Sainte-Justine à Montréal (Canada) entre 2001 et 2011. Parmi elles, 128 ont développé une récidive de PE à la grossesse successive. RÉSULTATS: Chez les femmes récidivantes (n = 128), les taux de prématurité et de RCIU étaient similaires dans les 2 épisodes de PE, bien que plus atteintes d'hypertension chronique (p = 0.001) et de diabète gestationnel (p = 0.021) dans leur seconde PE. Comparativement aux femmes non récidivantes (n = 255), les récidivantes (n = 128) présentaient, à leur première PE, un profil clinique caractérisé par un taux élevé de PE sévère (p < 0.001), éclampsie et critères adverses (p = 0.007). Le risque relatif de récidive de PE chez une femme avec ce profil clinique à sa première PE a été évalué à 1, 60 (95%IC: 1, 17 – 2, 18). CONCLUSION: La récidive de PE est associée à des taux similairement élevés de prématurité et de RCIU comparativement à la première PE. Les femmes qui à leur première PE ont un profil clinique défini par prééclampsie sévère, éclampsie ou présence de critères adverses sont plus à risque de récidive de PE à la grossesse subséquente. Mots clés: prééclampsie, récidive, issues périnatales, prématurité / OBJECTIVE: To assess whether a recurrent preeclampsia compared to the preeclampsia that occurred at the first pregnancy was more at risk of preterm delivery at < 37 weeks of gestation. Secondary outcomes were intrauterine growth restriction (IUGR) and maternal morbidity. STUDY DESIGN: We conducted a retrospective cohort study including 383 women with preeclampsia who delivered at Sainte-Justine Hospital in Montreal (Canada) from 2001 to 2011. Among these, 128 women developed a recurrent preeclampsia in their subsequent pregnancy. RESULTS: Among women with a recurrent preeclampsia (n = 128), no significant differences were found in the rates of preterm delivery and IUGR between the first and the subsequent pregnancy. Women with a recurrent preeclampsia were more at risk of chronic hypertension (p = 0.001) and gestational diabetes (p = 0.02) in their second pregnancy. Furthermore, women with recurrent preeclampsia had, at their first pregnancy, a higher rate of severe preeclampsia (p < 0.001), eclampsia and adverse criteria (p = 0.007), than women who experienced a single preeclampsia (n = 255). The Relative Risk to experience a recurrent preeclampsia at the second pregnancy, if a woman had the above criteria at the first pregnancy, was 1.60 (95%CI 1.17 - 2.18). CONCLUSION: Recurrent preeclampsia was not associated with a higher rate of preterm delivery. Women who experienced a severe preeclampsia, an eclampsia or adverse criteria in a first pregnancy were more at risk to have a recurrent preeclampsia in the subsequent pregnancy. Key words: preeclampsia, recurrence, perinatal outcome, and preterm delivery

Submitted by Vanessa Rocha Ribeiro null (va_rocharibeiro@aluno.ibb.unesp.br) on 2017-03-08T15:02:28Z No. of bitstreams: 1 Dissertação Vanessa Rocha Ribeiro.pdf: 3324263 bytes, checksum: c662d084e05ff3055723d93ba4f2eee2 (MD5) / Approved for entry into archive by LUIZA DE MENEZES ROMANETTO (luizamenezes@reitoria.unesp.br) on 2017-03-13T14:49:32Z (GMT) No. of bitstreams: 1 ribeiro_vr_me_bot.pdf: 3324263 bytes, checksum: c662d084e05ff3055723d93ba4f2eee2 (MD5) / Made available in DSpace on 2017-03-13T14:49:32Z (GMT). No. of bitstreams: 1 ribeiro_vr_me_bot.pdf: 3324263 bytes, checksum: c662d084e05ff3055723d93ba4f2eee2 (MD5) Previous issue date: 2017-02-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução: A pré-eclâmpsia (PE) é uma patologia obstétrica e uma das principais causas de morbimortalidade materna e fetal. Na PE ocorre um estado de má adaptação da tolerância imunológica, caracterizada por ativação anormal do sistema imune inato e adaptativo. As células T reguladoras (Treg) representam uma população de linfócitos T responsáveis pela manutenção da tolerância e controle da inflamação, enquanto células Th17 medeiam diferentes tipos de reações inflamatórias. Portanto, o balanço entre células Treg e Th17 pode ser crítico para a tolerância ao feto e prevenção da PE. Objetivo: Avaliar as subpopulações de células T CD4+ (Th1, Th2, Th17 e Treg) e o perfil de citocinas produzido por essas células, em gestantes portadoras de pré-eclâmpsia, classificadas em PE precoce e PE tardia. Métodos: Foram estudadas 60 gestantes, sendo 20 normotensas e 40 portadoras de PE, pareadas pela idade gestacional. As gestantes com PE foram classificadas de acordo com o aparecimento das manifestações clínicas em PE precoce (< 34 semanas de gestação; n=20) e PE tardia (≥ 34 semanas de gestação; n=20). Células mononucleares do sangue periférico (PBMCs), obtidas das gestantes foram avaliadas quanto à produção de citocinas pró e anti-inflamatórias e à expressão de fatores de transcrição envolvidos na caracterização das subpopulações de células T CD4+. A expressão dos fatores de transcrição intracitoplasmáticos de células Th1 (T-bet), Th2 (GATA-3), Th17 (RORc) e Treg (FoxP3) foi avaliada por citometria de fluxo e a expressão gênica desses fatores de transcrição foi determinada por PCR em tempo real com transcrição reversa (RT-qPCR), logo após a colheita de sangue para avaliação da expressão endógena dessas diferentes subpopulações de células T. A determinação das citocinas de perfil Th1 (IFN-γ e TNF-α), Th2 (IL-4), Th17 (IL-6, IL-17 e IL-22) e Treg (IL-10 e TGF-β1) foi realizada no plasma das gestantes pela técnica de ELISA. Os resultados foram analisados por meio de testes paramétricos ou não paramétricos com nível de significância de 5%. Resultados: Os perfis inflamatórios Th1 e Th17 foram identificados por aumento significativo da média de intensidade de fluorescência (MIF) e da percentagem de células expressando os fatores de transcrição específicos nas gestantes portadoras de PE precoce e PE tardia em relação aos grupos de gestantes normotensas com idade gestacional correspondente. A percentagem de células Th17 foi significativamente maior nas gestantes com PE precoce do que nas com PE tardia. Por outro lado, a análise dos perfis anti-inflamatórios Th2 e Treg mostrou que a percentagem de células expressando GATA-3 e FoxP3 foi significativamente menor nos grupos de PE precoce e PE tardia comparados aos grupos de normotensas, enquanto a comparação entre gestantes pré-eclâmpticas mostrou percentagem de células Treg significativamente menor nas gestantes portadoras de PE precoce. A expressão gênica do fator de transcrição T-bet por PBMCs não mostrou diferenças significativas entre os grupos de gestantes pré-eclâmpticas e de normotensas. Aumento significativo da expressão gênica do fator de transcrição RORc e diminuição da expressão dos genes GATA-3 e FoxP3 foram observados nos grupos de gestantes pré-eclâmpticas em relação aos grupos de normotensas de idade gestacional correspondente. Entre as gestantes pré-eclâmpticas, encontrou-se menor nível transcricional do fator de transcrição GATA-3 na PE precoce. Os níveis plasmáticos das citocinas IFN-γ, IL-6, IL-17 e TNF-α foram significativamente maiores nas gestantes portadoras de PE, enquanto as concentrações de IL-10 e TGF-β1 foram significativamente menores em comparação aos grupos de gestantes normotensas correspondentes. Observaram-se ainda, maiores níveis de IL-6, IL-17, TGF-β1 e TNF-α na PE precoce do que na PE tardia. A expressão proteica de IL-4 (perfil Th2) e IL-22 (perfil Th17), não apresentou diferença significativa entre os grupos estudados. Conclusão: Os resultados demonstram que o balanço entre células Treg e Th17 é deficiente na PE, havendo polarização para perfil Th17 na PE precoce. Esse desbalanço pode ser atribuído ao predomínio de citocinas pró-inflamatórias sobre as anti-inflamatórias, presentes na circulação de gestantes portadoras de pré-eclâmpsia. / Introduction: Preeclampsia (PE) is an obstetric pathology and one of the main causes of maternal and fetal morbidity and mortality. In PE there is a state of maladaptation of immunological tolerance, characterized by abnormal activation of the innate and adaptive immune system. Regulatory T cells (Treg) represent a population of T lymphocytes responsible for tolerance maintenance and inflammation control, whereas Th17 cells mediate different types of inflammatory reactions. Therefore, the balance between Treg and Th17 cells may be critical for fetal tolerance and PE prevention. Objective: To evaluate the subpopulations of CD4+ T cells (Th1, Th2, Th17 and Treg) and the cytokine profile produced by these cells in pregnant women with PE, classified in early-onset PE and late-onset PE. Methods: Sixty pregnant women, 20 normotensive and 40 preeclamptic women, matched by gestational age, were studied. Pregnant women with PE were classified according to clinical manifestations in early-onset PE (<34 weeks gestation; n = 20) and late-onset PE (≥ 34 weeks gestation; n = 20). Peripheral blood mononuclear cells (PBMCs) obtained from pregnant women were evaluated for the production of pro and anti-inflammatory cytokines and expression of transcription factors involved in the characterization of CD4+ T cell subpopulations. Expression of the intracytoplasmic transcription factors of Th1 (T-bet), Th2 (GATA-3), Th17 (RORc) and Treg (FoxP3) cells was assessed by flow cytometry and the gene expression of these transcription factors was determined by reverse-transcription quantitative polymerase chain reaction (RT-qPCR) shortly after blood collection to evaluate the endogenous expression of these different T-cell subpopulations. The cytokine profile of Th1 cells (IFN-γ and TNF-α), Th2 (IL -4), Th17 (IL-6, IL-17 and IL-22) and Treg (IL-10 and TGF-β1) were measured in the plasma of the pregnant women by the ELISA. The results were analyzed using parametric or non-parametric tests with a significance level of 5%. Results: Th1 and Th17 inflammatory profiles were identified by a significant increase in mean fluorescence intensity (FMI) and by the percentage of cells expressing specific transcription factors in pregnant women with early-onset PE and late-onset PE in relation to the normotensive groups with corresponding gestational age. The percentage of Th17 cells was significantly higher in early-onset PE than in late-onset PE group. On the other hand, analysis of Th2 and Treg anti-inflammatory profiles showed percentages of cells expressing GATA-3 and FoxP3 significantly lower in the early- and late-onset PE groups compared to the normotensive groups, whereas the comparison between preeclamptic groups showed significantly lower percentage of Treg cells in pregnant women with early-onset PE. The gene expression of the T-bet transcription factor by PBMCs did not show significant differences between the preeclamptic and normotensive pregnant groups. Significant increase in the gene expression of RORc and decrease in the expression of the GATA-3 and FoxP3 genes were observed in both groups of preeclamptic women compared with the normotensive ones of corresponding gestational age. Among the preeclamptic pregnant women lower transcriptional level of GATA-3 transcription factor was detected in early-onset PE. Plasma levels of the cytokines IFN-γ, IL-6, IL-17 and TNF-α were significantly higher in pregnant women with PE, whereas IL-10 and TGF-β1 concentrations were significantly lower than in the normotensive corresponding groups. It was also observed higher levels of IL-6, IL-17, TGF-β1 and TNF-α in early-onset than in late-onset PE group. Protein expression of IL-4 (Th2 profile) and IL-22 (Th17 profile), did not show significant differences between the groups studied. Conclusion: The results show that the balance between Treg and Th17 cells is deficient in PE, with polarization to the Th17 profile in early-onset PE. This imbalance can be attributed to the predominance of pro-inflammatory cytokines over the anti-inflammatory ones present in the circulation of pregnant women with preeclampsia. / FAPESP: 2014/25124-7 / FAPESP: 2012/24697-8

Placental function is central for normal pregnancy and in many of the major pregnancy disorders. We used magnetic resonance imaging techniques to investigate placental function in normal pregnancy, in early and late preeclampsia and in intrauterine growth restriction. We also investigated maternal body mass index and height, as risk factors for preeclampsia. A high body mass index and a short maternal stature increase the risk of preeclampsia, of all severities. The association seems especially strong between short stature and early preeclampsia, and a high body mass index and late preeclampsia. (Study I) Using diffusion-weighted magnetic resonance imaging, we found that the placental perfusion fraction decreases with increasing gestational age in normal pregnancy. Also, the placental perfusion fraction is smaller in early preeclampsia, and larger in late preeclampsia, compared with normal pregnancies. That these differences are in opposite directions, suggests that there are differences in the underlying pathophysiology of early and late preeclampsia. (Study II) Using magnetic resonance spectroscopy, we found that the phosphodiester spectral intensity fraction and the phosphodiester/phosphomonoester spectral intensity ratio increases with increasing gestational age. Also, we found that the phosphodiester spectral intensity fraction and the phosphodiester/phosphomonoester spectral intensity ratio are higher in early preeclampsia, compared with early normal pregnancy. These findings indicate increased apoptosis with increasing gestational age in normal pregnancy, and increased apoptosis in early preeclampsia. (Study III) The placental perfusion fraction is smaller in intrauterine growth restriction than in normal pregnancy. Fetal growth, Doppler blood flow in maternal and fetal vessels, infant birth weight and plasma markers of placental function are all correlated to the placental perfusion fraction. The placental perfusion fraction examination seems therefore to offer a fast, direct estimate of the degree of placental dysfunction. (Study IV) In conclusion: Our findings in studies I-III all support the hypothesis of partly different pathophysiology between early and late preeclampsia, and suggest a strong link between early preeclampsia and placental dysfunction. Study IV shows that the placental perfusion fraction has potential to contribute to the clinical assessment of placental dysfunction.

Orientador: Maria Terezinha Serrão Peraçoli / Resumo: Introdução: A pré-eclâmpsia (PE) é uma patologia obstétrica e uma das principais causas de morbimortalidade materna e fetal. Na PE ocorre um estado de má adaptação da tolerância imunológica, caracterizada por ativação anormal do sistema imune inato e adaptativo. As células T reguladoras (Treg) representam uma população de linfócitos T responsáveis pela manutenção da tolerância e controle da inflamação, enquanto células Th17 medeiam diferentes tipos de reações inflamatórias. Portanto, o balanço entre células Treg e Th17 pode ser crítico para a tolerância ao feto e prevenção da PE. Objetivo: Avaliar as subpopulações de células T CD4+ (Th1, Th2, Th17 e Treg) e o perfil de citocinas produzido por essas células, em gestantes portadoras de pré-eclâmpsia, classificadas em PE precoce e PE tardia. Métodos: Foram estudadas 60 gestantes, sendo 20 normotensas e 40 portadoras de PE, pareadas pela idade gestacional. As gestantes com PE foram classificadas de acordo com o aparecimento das manifestações clínicas em PE precoce (< 34 semanas de gestação; n=20) e PE tardia (≥ 34 semanas de gestação; n=20). Células mononucleares do sangue periférico (PBMCs), obtidas das gestantes foram avaliadas quanto à produção de citocinas pró e anti-inflamatórias e à expressão de fatores de transcrição envolvidos na caracterização das subpopulações de células T CD4+. A expressão dos fatores de transcrição intracitoplasmáticos de células Th1 (T-bet), Th2 (GATA-3), Th17 (RORc) e Treg (FoxP3) foi avaliada por c... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

T-cells are present in the immune system to fight against invaders. Once their job is done, suppressing their activity is an important step in maintaining a proper immune response. Myeloid derived suppressor cells (MDSCs) are immune cells that suppress T-cell activity. Currently, MDSCs are defined as a heterogeneous population of immature cells that are derived in the bone marrow and travel to the site of inflammation or cancer. Two major subtypes of MDSCs have been identified in mice and humans, monocyte-like MDSCs (M-MDSC) and granulocyte MDSCs (G-MDSC). G-MDSCs typically make up the majority of the total population of MDSCs but are less T-cell suppressive than M-MDSCs. One of the major problems in the study of MDSCs is that the current marker system for subtypes does not differentiate between precursor MDSCs (lacking suppressive ability) and functional MDSCs (those with suppressive ability). Therefore, using cancer models in mice, we investigated the development and potential to classify precursor MDSCs from functional MDSCs. While MDSCs have been highlighted as a target cell to inhibit in cancer, in other conditions, such as pregnancy, MDSCs have been shown to be beneficial in maintaining a normal pregnancy. Therefore, targeting the increase of MDSCs in abnormal pregnancy conditions like pre-eclampsia may act as a prevention or therapeutic strategy. Finally, it is known that many dietary components can act as modulators of immune cells. Specifically, the polyphenol like phytochemical, curcumin has been shown to act as an anti-inflammatory agent with the potential to modulate multiple immune cells. Therefore, we propose two different studies to investigate the potential of curcumin as either an inhibitor and/or promotor of MDSCs in a disease-specific context. Together the role of phytochemicals as immunomodulators of MDSCs is still very young, in part due to the complexity of phytochemicals themselves, but the studies cited here provide evidence that the field is ripe for additional questions to be asked.

Under år 2003-2009 utgjorde hypertensiva sjukdomar, såsom eklampsi och preeklampsi, 14,0% av värdens mödradödlighet. Preeklampsi kännetecknas vanligtvis av kliniska observationer av hypertoni och signifikant proteinuri i graviditetens andra trimester. Inom diagnostiken används en riskbedömningsprogramvara som kan beräkna vilken sannolikhetsgrad den havande kvinnan har för att utveckla preeklampsi. Förutom mätning av blodtryck och proteinuri har biomarkören placenta growth factor 1 (PlGF-1) visat ett högt prediktivt värde vid bedömningen. Studien syftade till att kartlägga och fördjupa sig i metoderna som analyserar biomarkören samt verifiera metoden för PlGF på instrumentet Brahms Kryptor compact plus. Fördjupningen baserades på granskning av vetenskapliga artiklar och resulterade i två manuella och tre automatiserade metoder. Metoden Quantikine användes i 47% av artiklarna och konstaterades som studiens golden standard. Vid jämförelse av metoderna sågs en lägre bakgrundsstörning, en högre sensitivitet samt en kortare analystid hos de automatiserade metoderna. Den laborativa verifieringen innefattade bestämning av överensstämmelse med externt laboratorium, beräkning av instrumentets provsmitta mellan höga och låga prov samt kvantifiering av inomserie- och mellanliggande precision. Verifieringen resulterade i en god överensstämmelse (r=0,953, p=0,327) med det externa laboratoriet, en konstaterad provsmitta på 0,04% samt en god precision inom leverantörens angivelser. / Between 2003-2009 hypertensive disorders as eclampsia and preeclampsia constituted 14.0% of the world’s maternal mortality. Preeclampsia characterize as clinical observations of hypertension and significant proteinuria in the second trimester of pregnancy. In diagnostics a risk assessment software is normally used to estimate the probability of developing the disorder. Besides calculating the blood pressure and proteinuria, the placenta growth factor 1 (PlGF-1) has proven to possess a high predictive value. The study’s aim was to chart the different methods used to quantify the biomarker and verify the method for PlGF on Brahms Kryptor compact plus. The recess was based on review of scientific articles and resulted in the findings of two manual and three automated methods. The method Quantikine was used in 47% of the articles and was seen as the golden standard of the study. When comparing the methods a lower signal to noise-ratio, a higher sensitivity and a shorter assay time was observed in the automated methods. The verification contained determination of compliance with an external laboratory, calculation of carry over and quantification of inter-assay and intra-assay precision. The verification resulted in a good compliance (r=0.953, p=0,327) with the external laboratory, a carry over at 0,04% and a good precision within the providers indication.