Placental angiogenesis markers sFlt-1 and PIGF: response to cigarette smoke

OBJECTIVE: Excess soluble vascular endothelial growth factor receptor, fms- like tyrosine kinase- 1 ( sFlt- 1), and reduced placental growth factor ( PlGF) mediate the genesis of preeclampsia. Cigarette smoking reduces the risk of preeclampsia. We hypothesized that placental secretion of sFlt- 1 and PlGF was affected by exposure to cigarette smoke extract. STUDY DESIGN: Term placental villous explants were cultured with cigarette smoke extract. Media were analyzed for sFlt- 1 and PlGF. Apoptosis was measured by TUNEL staining. Results are reported as sFlt- 1 or PlGF picogram/ milliliter/ milligram wet weight of explant. RESULTS: Exposure to cigarette smoke extract reduced secretion of sFlt- 1 in a dose- dependent manner. There was no difference in apoptosis. In contrast with sFlt- 1, PlGF did not decline when incubated with cigarette smoke extract. CONCLUSION: Exposure of placental villous explants to cigarette smoke extract results in a proangiogenic state with reduced sFlt- 1 and relative abundance of PlGF. This is the reverse of changes that are seen in preeclampsia and may explain the reduction of preeclampsia in smokers.