Precision Biomarkers of pre-eclampsia

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Preeclampsia is a hypertensive disorder of pregnancy which claims the lives of thousands of mothers and babies every year. It is the major cause of both maternal and fetal morbidity and mortality worldwide. There is no cure for preeclampsia but maintaining tight blood pressure control from the earliest possible gestation, alongside frequent medical reviews to identify progression of the disease, allows timely delivery to obtain the best outcome for both mum and baby. Further, the recently discovered benefits of aspirin therapy before 16 weeks to prevent the development of the disease clearly demonstrates the need for acurate test to predict which patients are most likely to develop preeclampsia in their pregnancy. The current means sought to identify patients at risk of future preeclampsia is based on maternal risk factors. there is growing interest in detecting predictive biomarkers in the maternal circulation that are released as 'distress signals' from organs affected by pre-eclampsia: the placenta or the maternal endothelium. Recent NICE guidelines encourage the use of soluble Flt1 (sFlt1) and placental growth factor (PlGF) in the investigation of symptomatic pregnant women. Recent adoption by NHS clinical laboratory services of these guidlines, offers access to valuable retrospective real world serum samples from pregnancies with clearly defined outcomes. This project will offer the opportunity to explore added value of additional promising biomarkers and enable the student to develop a wide range of skills in translational biomarker research from laboratory methods to biomarker performance and development of regression modelling. The project will also focus on investigations toward understanding the mechanisms by which such biomarkers may contribute to disease pathogenesis - which is key in allowing better understanding of the underlying pathophysiology; this part will offer the opportunity to develop cutting edge skills in placental biology and molecular basis of disease.