Preeclampsia is still a threat to pregnant women’s health world-wide and in industrialized countries the most common cause of prematurity, including all potential complications of preterm delivery and its sequelae later in life. In the pathogenesis of preeclampsia, increased expression of soluble FMS-like tyosine kinase 1 (sFlt-1) acts as an antagonist by scavenging and neutralizing the pro-angiogenic vascular endothelial growth factor (VEGF) and placental growth factor (PIGF). The resulting angiogenic imbalance may progress to enothelial dysfunction and thrombotic microangiopathy, manifesting with seizures, stroke, or multiorgan failure. Effective therapeutic and prophylactic measures are lacking, limiting interventional options to premature termination of pregnancy. Thus, therapies for preeclampsia are still an unmet and urging medical need. 

The underlying invention aims at using an apheresis based approach with recombinant monomeric (moVEGF¹⁶⁵)or two single-chain dimers of VEGF¹⁶⁵ (scVEGF¹⁶⁵). Both compounds enhance binding affinity to sFlt-1 and efficiently reduce or eliminate sFlt-1 levels from plasma of preclampsia affected women. Compared to approaches based on antibodies in the art, the use of both compoundsas a ligand has the additional effect that bound VEGF and PIGF are displaced and released from sFlt-1. Overall, this minimizes the risk of life-threatening conditions and, in particular, restores uterine vascularization and establishment of uteroplacental circulation.