Neuron-specific enolase and angiogenic markers in preeclampsia

Managadze I.D., Murashko A.V., Sidorova I.S., Chilova R.A.

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia

In the context of exploration of the neurogenic neuroimmune genesis of preeclampsia (PE), it is relevant to investigate the relationship between the markers of fetal brain neurocorticogenesis and angiogenic imbalance as potentially valuable prognostic and diagnostic targets. 
Objective. To assess serum levels of neuron-specific enolase (NSE) and angiogenic factors – soluble FMS-like tyrosine kinase-1(sFLT-1) and placental growth factor (PlGF) in pregnant women with PE, in women at high risk of developing PE, and in women with normal pregnancy.
Materials and methods. The single-center study included 30 patients, who were divided into three groups. The study group included 10 patients with PE). The risk group included 10 patients with risk factors for PE). The control group included (10 somatically healthy patients). Venous blood samples were collected from all pregnant women to determine serum NSE, sFlt-1, PlGF levels and the sFlt-1/PlGF ratio using enzyme-linked immunosorbent assay (ELISA). 
Results. The gradient of increasing serum levels of NSE were observed in the control group (4.0 ng/mL) compared to the risk group (8.0 ng/mL) and the PE group (13.5 ng/mL). The differences between the groups were statistically significant (p<0.001). Increased levels of NSE in the risk group compared to the control group indicates subclinical structural damage of neurons and impaired blood-brain barrier permeability before the manifestation of common symptoms of PE. Angiogenic imbalance in PE was confirmed. In the PE group, the sFlt-1 level was significantly higher – 8962 pg/mL compared to the control group – 2448 pg/mL (p<0.001). The sFlt-1/PlGF ratio was significantly higher both in the PE group – 72.0 and the risk group – 80.0 compared to the control group – 21.0 (p< 0.001). There were no statistically significant differences between the PE group and the risk group in a number of angiogenic parameters, that confirms the commonality of pathogenetic mechanisms and justifies identification of the risk group as a diagnostic category.
Conclusion. Significantly elevated maternal serum levels of neuron-specific enolase is observed in preeclampsia, that indicates structural damage to neurons and blood-brain barrier integrity disruption. Elevated NSE levels in the high-risk group indicates the potential prognostic value of this marker. The combined assessment of neuron-specific and angiogenic markers opens broad diagnostic possibilities in PE, integrating placental-vascular and neuroimmune disturbances, a differentiated approach to phenotyping this complication, and predicting short- and long-term fetal neurodevelopmental outcomes.

Authors' contributions. Managadze I.D., Murashko A.V., Sidorova I.S., Chilova R.A. – study concept and design, manuscript editing; Managadze I.D. – collection and analysis of literature data, manuscript writing. 
Conflicts of interest. The authors confirm that they have no conflicts of interest.
Funding. The study was carried out without any sponsorship.
Ethical Approval. The study was approved by the local Ethics Committee of Sechenov University (approval No. 23-25 of  November 13, 2025).
Generative Artificial Intelligence. No generative AI was used in preparing this article.
Patient Consent for Publication. The patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Managadze I.D., Murashko A.V., Sidorova I.S., Chilova R.A. 
Neuron-specific enolase and angiogenic markers in preeclampsia.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (8): 101-109 (in Russian)
https://dx.doi.org/10.18565/aig.2026.83

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About the Authors

Ioanna D. Managadze, Resident and PhD student at the Department of Obstetrics and Gynecology No 1, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(499)248-67-29, ktb1966@mail.ru,
https://orcid.org/0000-0001-8745-9372
Andrey V. Murashko, Dr. Med. Sci., Professor, Professor at the Department of Obstetrics and Gynecology No. 1, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(499)248-67-29, murashkoa@mail.ru, https://orcid.org/0000-0003-0663-2909
Iraida S. Sidorova, Dr. Med. Sci., Professor, Academician of the RAS, Merited Scholar of the Russian Federation, Merited Doctor of the Russian Federation, Professor at the Department of Obstetrics and Gynecology №1, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
(Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(499)248-67-29, sidorovais@yandex.ru, https://orcid.org/0000-0003-2209-8662
Raisa A. Chilova, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology No 1, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8, bld. 2, +7(499)248-67-29, chilova_r_a@staff.sechenov.ru, https://orcid.org/0000-0001-6331-3109
Corresponding author: Ioanna D. Managadze, ktb1966@mail.ru

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