NEW YORK (Reuters Health) - Greek researchers have identified an allele of the VEGF gene that appears to increase the risk of recurrent pregnancy loss.
Up to 50% of repeat miscarriages remain unexplained, Dr. Dimitrios Papazoglou of the Medical School of Alexandroupolis and colleagues note in their report in the April issue of Fertility and Sterility.
There is evidence from animal and human studies that abnormalities in vascularization of the uterus and placenta may be involved in spontaneous pregnancy loss, they add, while gene knockout studies support a central role for VEGF in fetal and placental angiogenesis.
To investigate whether variations in VEGF might play a role in recurrent miscarriage, the researchers tested for the prevalence of four common functional VEGF single nucleotide polymorphisms in 52 patients with at least three idiopathic pregnancy losses, along with 82 women who had given birth to at least two healthy children and had no miscarriages. All of the women in the control group were postmenopausal, to eliminate the chance that they might have miscarriages after being included in the study.
The researchers examined the prevalence of -2578C/A, -1154G/A, -634G/C, and 936C/T in both groups, and found women who miscarried repeatedly were nearly twice as likely to be homozygous for the -1154A polymorphism of VEGF compared with the control group. None of the other variants showed a significant association with recurrent spontaneous abortion.
“The presence of the -1154A allele has been associated with lower VEGF production,” Dr. Papazoglou told Reuters Health. The gene variant has also been linked to “disorders where angiogenesis and/or vasculogenesis are major determinants of the physiological or pathophysiological processes like acute renal allograft rejection, rheumatoid arthritis, diabetic retinopathy, amyotrophic lateral sclerosis,” he added, as well as different aspects of malignancies including prostate cancer, cutaneous malignant melanoma, non-small cell lung cancer and breast cancer.
Dr. Papazoglou and his colleagues suggest that reduced VEGF expression may result in placental vasculature with “an abnormally high apoptotic tendency,” which in turn would increase the likelihood of placental detachment and miscarriage.
Source: Fertil Steril 2005; 83:959-963. [ Google search on this article ]
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