{"id":9105,"date":"2026-03-04T16:38:09","date_gmt":"2026-03-04T15:38:09","guid":{"rendered":"https:\/\/fhu-premimpact.org\/?page_id=9105"},"modified":"2026-04-13T15:29:17","modified_gmt":"2026-04-13T13:29:17","slug":"impact-du-depistage-de-la-preeclampsie-au-premier-trimestre-sur-la-morbidite-perinatale-et-maternelle-un-essai-randomise-multicentrique-copie","status":"publish","type":"page","link":"https:\/\/fhu-premimpact.org\/en\/recherche\/impact-du-depistage-de-la-preeclampsie-au-premier-trimestre-sur-la-morbidite-perinatale-et-maternelle-un-essai-randomise-multicentrique-copie\/","title":{"rendered":"APHERESE-2"},"content":{"rendered":"\n
\n
\n

Investigateur coordonnateur : <\/p>\n\n\n\n

Vassilis Tsatsaris<\/strong><\/a> :Maternit\u00e9 de Port Royal, H\u00f4pital Cochin AP-HP – Paris<\/p>\n\n\n\n

Responsable scientifique<\/p>\n\n\n\n

\u00c9douard Lecarpentier<\/strong> <\/mark>: Service de Gyn\u00e9cologie Obst\u00e9trique, H\u00f4pital Intercommunal de Cr\u00e9teil
Jean GUIBOURDENCHE<\/strong><\/mark> : Laboratoire d\u2019Hormonologie, DMU Biophygen, H\u00f4pital Cochin, AP-HP<\/p>\n<\/div>\n<\/div>\n\n\n\n

D\u00e9veloppement d\u2019une bio-collection pour approche
th\u00e9rapeutique innovante de la pr\u00e9-\u00e9clampsie par
aph\u00e9r\u00e8se sp\u00e9cifique de sFlt-1 et lib\u00e9ration de PlGF
endog\u00e8ne<\/h2>\n\n\n\n

<\/p>\n\n\n\n

Justification scientifique<\/h3>\n\n\n\n
li\u00e9e \u00e0 une dysfonction placentaire responsable de la lib\u00e9ration dans la circulation maternelle de facteurs induisant une dysfonction endoth\u00e9liale maternelle g\u00e9n\u00e9ralis\u00e9e. Parmi ces facteurs, un des plus significatifs est le sFlt-1, qui est la forme soluble du r\u00e9cepteur au VEGF (facteur de croissance endoth\u00e9lial vasculaire) et au PlGF (facteur de croissance placentaire). Le sFlt-1 se lie au PlGF et au VEGF libres dans la circulation maternelle r\u00e9duisant ainsi leur biodisponibilit\u00e9 pour la forme membranaire du r\u00e9cepteur et provoquant alors une inhibition des effets de ces facteurs de croissance sur l\u2019endoth\u00e9lium maternel. Cette alt\u00e9ration de la balance
pro\/anti-angiog\u00e9nique est un facteur causal dans la physiopathologie de la pr\u00e9-\u00e9clampsie et constitue une cible th\u00e9rapeutique prioritaire pour cette complication grave de la grossesse pour laquelle nous ne disposons actuellement pas de traitement. La dysfonction placentaire est responsable sur le versant foetal d\u2019un retard de croissance intra-ut\u00e9rin (RCIU). Le RCIU est souvent associ\u00e9 \u00e0 la pr\u00e9-\u00e9clampsie mais un certain nombre de patientes pr\u00e9sentent l\u2019atteinte maternelle ou l\u2019atteint f\u0153tale exclusivement. Les m\u00e9canismes physiopathologiques expliquant ces formes dissoci\u00e9es ne sont pas bien compris actuellement.
L\u2019approche que nous avons choisie, est de d\u00e9velopper un dispositif d\u2019aph\u00e9r\u00e8se sp\u00e9cifique du sFLT-1 par une approche ligand comp\u00e9titive. L\u2019objectif est le d\u00e9veloppement d\u2019un dispositif m\u00e9dical pour le traitement de la pr\u00e9-\u00e9clampsie, permettant de capter le sFLT-1 par un ligand ayant une forte affinit\u00e9 pour le r\u00e9cepteur, ce qui permet de lib\u00e9rer le VEGF et le PlGF et de r\u00e9tablir une balance angiog\u00e9nique physiologique. Le projet, financ\u00e9 par l\u2019ANR (Projet APHERESE 2 New therapeutic strategy against preeclampsia: Angiogenic switch to Physiological state by Extracorporeal Removal of sFlt-1 and release of PlGF), est au stade pr\u00e9clinique avec le d\u00e9veloppement d\u2019une colonne fonctionnalis\u00e9e qui est test\u00e9e ex-vivo. Des \u00e9chantillons sanguins de femmes enceintes seront utilis\u00e9s pour tester et optimiser la capacit\u00e9 des colonnes d\u2019aph\u00e9r\u00e8se \u00e0 capter le sFlt-1 le plus sp\u00e9cifiquement possible et \u00e0 r\u00e9tablir une balance angiog\u00e9nique physiologique. Le projet permettra aussi de mener des travaux pour mieux comprendre le profil pro\/antiangiog\u00e9nique dans les formes dissoci\u00e9es de dysfonctions placentaires (pr\u00e9-\u00e9clampsie seule et RCIU seul).<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Objectifs<\/h3>\n\n\n\n

Objectif principal : Collecter des \u00e9chantillons sanguins de femmes enceintes (avec une grossesse normale ou compliqu\u00e9e de pr\u00e9-\u00e9clampsie et\/ou de RCIU) pour la mise au point d\u2019une technique d\u2019aph\u00e9r\u00e8se permettant l\u2019adsorption sp\u00e9cifique du r\u00e9cepteur soluble sFlt-1 et restaurant une balance angiog\u00e9nique physiologique.<\/p>\n\n\n\n



Objectifs secondaires: <\/p>\n\n\n\n

    \n
  • \u00c9valuation in-vitro du pouvoir angiog\u00e9nique du s\u00e9rum\/plasma avant et apr\u00e8s aph\u00e9r\u00e8se.;<\/li>\n\n\n\n
  • \u00c9tude des diff\u00e9rents facteurs plasmatiques li\u00e9s \u00e0 la colonne d\u2019aph\u00e9r\u00e8se (\u00e9tude la sp\u00e9cificit\u00e9 de la capture);<\/li>\n\n\n\n
  • Constitution d\u2019une collection biologique sanguins et urinaires, permettant l\u2019\u00e9tude de nouveaux biomarqueurs et de nouvelles approches th\u00e9rapeutiques de la pr\u00e9-\u00e9clampsie.<\/li>\n<\/ul>\n\n\n\n

    Sch\u00e9ma exp\u00e9rimental<\/h3>\n\n\n\n

    Etude monocentrique non interventionnelle.<\/p>\n\n\n\n

    Population concern\u00e9e<\/h3>\n\n\n\n

    Femmes enceintes pr\u00e9sentant une pr\u00e9-\u00e9clampsie entre 20+0 et 40+6 semaines d\u2019am\u00e9norrh\u00e9es (SA)<\/p>\n\n\n\n

    Femmes enceintes pr\u00e9sentant pr\u00e9sentant un RCIU<3\u00b0P (courbe OMS) entre 20+0 et 40+6 SA<\/p>\n\n\n\n

    Femmes enceintes pr\u00e9sentant une grossesse normale entre 20+0 et 40+6 SA<\/p>\n\n\n\n

    Nombre de sujets s\u00e9lectionn\u00e9s<\/h3>\n\n\n\n

    250 femmes.<\/p>\n\n\n\n

    Dur\u00e9e de la recherche<\/h3>\n\n\n\n
      \n
    • dur\u00e9e d\u2019inclusion : 24 mois<\/li>\n\n\n\n
    • dur\u00e9e de participation : 1 jour<\/li>\n<\/ul>\n\n\n\n

      Nombre d\u2019inclusions pr\u00e9vues par centre et par mois<\/h3>\n\n\n\n

      10 inclusions par mois<\/p>\n\n\n\n

      PROMOTEUR : AP-HP<\/h3>\n\n\n\n

      Source de financement : ANR<\/h3>\n\n\n\n

      Etat d’avancement <\/h3>\n\n\n\n

      L’\u00e9tude a d\u00e9marr\u00e9 le 9 f\u00e9vrier 2026<\/mark>.<\/p>\n\n\n\n

      Au 27 f\u00e9vrier 2026, nous comptabilisons 4 patientes dans l’\u00e9tude<\/strong>.<\/mark><\/p>\n\n\n\n

      <\/p>\n","protected":false},"excerpt":{"rendered":"

      Investigateur coordonnateur : Vassilis Tsatsaris :Maternit\u00e9 de Port Royal, H\u00f4pital Cochin AP-HP – Paris Responsable scientifique \u00c9douard Lecarpentier : Service de Gyn\u00e9cologie Obst\u00e9trique, H\u00f4pital Intercommunal de Cr\u00e9teilJean GUIBOURDENCHE : Laboratoire d\u2019Hormonologie, DMU Biophygen, H\u00f4pital Cochin, AP-HP D\u00e9veloppement d\u2019une bio-collection pour approcheth\u00e9rapeutique innovante de la pr\u00e9-\u00e9clampsie paraph\u00e9r\u00e8se sp\u00e9cifique de sFlt-1 et lib\u00e9ration de PlGFendog\u00e8ne Justification scientifique […]<\/p>\n","protected":false},"author":87,"featured_media":0,"parent":241,"menu_order":31,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_editorskit_title_hidden":false,"_editorskit_reading_time":0,"_editorskit_is_block_options_detached":false,"_editorskit_block_options_position":"{}","_uag_custom_page_level_css":"","footnotes":""},"class_list":["post-9105","page","type-page","status-publish","hentry"],"yoast_head":"\nAPHERESE-2 - 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