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A Promising Cure For Preeclampsia

2012 September 16

Striking in the third trimester of pregnancy, preeclampsia is responsible for 70,000 worldwide maternal death. The hallmarks of the condition, are elevated maternal blood pressure and protein in the urine.  It ranks third, outpaced only by severe bleeding and infection , as the unfortunate cause of death of  pregnant mothers, the unborn and newborn babies.

But the medical community is now a step closer to isolating  the causes of preeclampsia. Dr. Ananth Karumanchi (Associate Professor of Medicine, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston Massachusetts) has uncovered a newly evident  molecular pathway that predicts preeclampsia. The promising discovery, was reported by Dr. Karumanchi in Berlin at the first ECRC “Franz-Volhard” symposium.  In the years ahead, the finding could result in breakthrough therapies to conquer preeclampsia.

It is believed that the true incidences of preeclampsia worldwide are often under reported. While, the ravages of the disease are experienced worldwide, manifestations are particularly brutal in poverty-stricken countries. Dr. Karumanch states” Preeclampsia is especially lethal in underdeveloped world where medical care and facilities for emergencies and for caring for premature babies are lacking.” Such disparities in treatment lead to a higher neonatal death rate.

Preeclampsia also can manifest itself with few obvious symptoms.  Many symptoms are subtle, and often mistaken as normal pregnancy complaints. Proper and routinely scheduled prenatal care will alert a pregnant woman if she has developed preeclampsia and afford her constant care.

Currently when a pregnant woman is diagnosed with preeclampsia doctors exercise every available effort to treat the mother and baby— without spurring early delivery.  The longer a baby is allowed to develop in the protection of the womb, the greater his chances of survival.    If the condition can’t be controlled, doctors will induce an early labor to save the life of the mother and baby. Preeclampsia is one of the primary causes of premature birth.

Preeclampsia is a condition that only exists in pregnancy. Birth of the baby, halts the occurrence of preclampsia. Yet, there is a risk factor later in life still faced by afflicted women of heart disease, high blood pressure and thyroid disorders.  Babies that are born prematurely also might face myriad health problems that span into adulthood.

Researchers have been hunting for early clues that would point to the development of preeclampsia.  If a mother could secure treatment prior to elevated display of symptoms it would bode well for safely lengthening the duration of the pregnancy and the overall health of the maternal-baby dyad.

Dr. Karumanchi uncovered the elusive causes of the condition at the molecular level. The trouble is rooted in the placenta, an organ of pregnancy which provides nourishment to the developing baby. The placenta also releases a set of two telltale proteins.

The first protein is known as the placental growth factor (PIGF).  This protein is responsible for the constructing of blood vessel pathways leading to the placenta. The counterpart protein to PIGF is Soluble frms-like tyrosine kinase or sFlt-1.  The task of the sFit-1 is to bind with the PIGF protein and prevent blood vessel growth.

In a healthy pregnancy the two opposing proteins are kept in balance.  But, Dr. Karumanchi and his team made an impressive realization that women with preeclampsia have an excess of sFit-1 and a shortage of PIGF. The imbalance creates a placenta that lacks sufficient blood supply. A lack of blood supply in the placenta equates to a lack of nourishment to the developing baby. Low levels of PIGF also cause the constriction of blood vessels which elevate maternal blood pressure. Additionally, the kidneys are impacted by the onset of proteinuria. The latter symptom is detected by high levels of protein in the maternal urine.

Due to amazing breakthrough of Dr. Karumanchi and his scientific team real world pilot studies have begun. Measurements of PIGF and sFlt-1 can now be made earlier in pregnancy, prior to the severe onset of hypertension and proteinuria. In a pilot study, excessive sFlt-1 was removed from maternal serum blood. Single staged treatments lowered the excessive sFlt-1 levels serum blood levels in woman diagnosed with preeclampsia  Multiple treatments, in early onset of the disease, successfully reduced excessive sFlt-1 levels, reduced proteinuria and stabilized hypertension. No harmful effects were observed to the maternal-baby-dyad. The risk of prematurity was lower and longer pregnancy durations were observed.

The pilot study was small. Dr. Karumanchi and his team have optimistically stress the need for additional studies to substantiate the findings of the pilot study and validate the procedures safety for mother and baby. Professor Ravi Thadhani conducted the pilot study alongside a team of nephrologists and obstetricians.

More information about this serious  pregnancy condition can be found at the Preeclampsia Foundation, click here.

Source: The Max Delbrück Center for Molecular Medicine









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