Study Authors Make Progress in Identifying Risk of Preeclampsia
A pregnancy complication known as preeclampsia is characterized by high blood pressure, occurring in roughly seven percent of pregnancies, and is the main cause of maternal mortality, not to mention premature death.
This condition can take place in various forms both in the early and late stages of pregnancy, making it hard to test and, thus, difficult to prevent or treat.
For the improvement of early detection of preeclampsia risk and better categorize potential subtypes of the disease, a team of researchers from Brigham and Women's Hospital evaluated a variety of maternal and placenta proteins, detecting several biomarkers that, from blood samples collected at a 12-week gestation, can contribute to the prediction of preeclampsia risk, and essentially, can investigate who is likely to develop more severe forms of conditions.
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Preeclampsia
According to Thomas McElrath, MD, Ph.D. at the Division of Maternal-Fetal Medicine in the Department of Obstetrics and Gynecology at the Brigham, preeclampsia was for so many years assumed to be a single disease.
"This study published in Scientific Reports is beginning to present that there are possibly multiple various forms of preeclampsia that come together in one common clinical presentation, and once we understand what the subgroups are, we may be more effective at testing or treating them."
The study authors were the first to investigate the connection between preeclampsia and proteins linked with CMPs or circulating microparticles, which, as described in the research as "virus-sized cellular secretions" containing small proteins and RNA, on top of the other cellular products.
Reports related to the study indicate that in humans and olden life forms alike, the CMPs' transmission is facilitating communication between cells by improving the functions of the receiving cells.
The study investigators found that during the 10th to 12th week of pregnancy, women who would develop preeclampsia later had different CMP-associated proteins already, compared to women who were eventually healthy while pregnant.
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CMP Proteins
When the research team investigated further how CMP proteins varied across the patients with preeclampsia, they discovered that more severe forms that have higher blood pressure and worse lab tests were linked to "proteins indicative of the complement system, a branch of the immune system identified as dysfunction.
The study authors detected another probable subgroup of preeclampsia associated with platelet dysfunction.
McElrath said, to develop treatments, there is a need for better information about which pathophysiologic pathways to target.
The notion that the study authors might be able to detect women who are most at risk early on during the pregnancy stage, which means that they might be able to develop more effective testing and treatments.
Specifically, this study used data from the LIFECODES Cohort of Brigham, which comprises records of roughly 6,000 pregnancies and is among the nation's largest pregnancy cohorts and specimen banks.
The researchers investigated CMP-associated proteins in more than 20 women diagnosed with severe preeclampsia forms at or prior to 34 weeks of gestation, of whom delivered prior to 35 weeks, and in 50 female individuals who gave birth after at least 37 weeks of gestation minus any evidence of hypertensive disease, which includes preeclampsia.
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