FGF2 and PTX3 plasma levels as potential biomarkers for early-onset pre-eclampsia

Pre-Eclampsia (PE) is characterized by an imbalance of angiogenic and inflammatory modulators, with clinical symptoms emerging after 20 weeks of gestation. Fibroblast Growth Factor-2 (FGF2) promotes angiogenesis, whereas the acute-phase protein Pentraxin-3 (PTX3) binds FGF2 and blocks its interaction with receptors. In this cross-sectional case-control study, we compared plasma levels of PTX3 and FGF2 in normotensive (NT) and PE pregnancies and evaluated their ability to discriminate early-onset (<34 weeks) from late-onset PE (≥ 34 weeks). PTX3 and FGF2 concentrations were quantified by sandwich ELISA in non-pregnant women (NP, n = 19) and in third-trimester samples from NT women (n = 29) and women with PE (n = 30; early-onset PE = 11, late-onset PE = 19). Both PTX3 and FGF2 levels were significantly higher (p < 0.05) in PE compared to NT pregnancies. Moreover, their concentrations in early-onset PE were, on average, twice as high as those observed in NT and late-onset PE groups. Pearson's correlation analysis revealed a negative association between PTX3 and FGF2 levels in PE (r = -0.5160; p = 0.0167). In conclusion, PTX3 and FGF2 are both elevated in PE, particularly in early-onset cases. Their inverse correlation suggests a disrupted PTX3-FGF2 axis that may contribute to the angiogenic deficit found in PE. These findings suggest that PTX3 and FGF2 are candidate biomarkers associated with disease severity and may contribute to a molecular signature related to early-onset PE. Further prospective studies are required to establish their predictive value and clinical applicability.