There’s no cure for women with preeclampsia other than giving birth.
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For decades, the medical community has searched for a cure for one of the most frightening and mysterious pregnancy complications: preeclampsia.
The condition is characterized by high blood pressure and protein in the urine, among other symptoms. If untreated, the condition can progress to eclampsia, a medical emergency that can cause seizures, stroke or death. About 70,000 women and 500,000 fetuses die of the condition every year. Women with the condition can get supportive treatment to lower their blood pressure, but the only real cure is to give birth, and the condition may still occur after giving birth.
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Researchers at Cedars-Sinai in Los Angeles, among other institutions, created an experimental treatment for preeclampsia.
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And if they have to give birth too early, their premature infants are at risk of multiple major health conditions, including vision problems, breathing problems, brain swelling and death.
Now, a new study from researchers at Cedars-Sinai in Los Angeles shows the potential of a new treatment that actually targets the cause of preeclampsia. Published in Nature Medicine on April 27, the small study looked at data from 16 women with the condition.
Dr. Ananth Karumanchi, director of the Renovascular Research Center at Cedars-Sinai and one of the study authors, explained that one hypothesis about why preeclampsia develops is that a malfunctioning placenta produces high amounts of a protein called sFlt-1, with toxic consequences to the body. But developing a drug to target that protein is complicated for a medical community hesitant about testing anything on pregnant women.
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“Whenever you think about giving a medicine into a pregnant woman, you really have to think about not just acute safety for mom and the baby, but more long-term safety,” he said.
Karumanchi and researchers from institutions around the globe decided on a “subtraction” approach by taking a page from dialysis treatments. They developed a monoclonal antibody that would in essence bind with the problematic protein. Next, a machine removed blood from patients, filtered out the damaging protein and then returned the blood to the patients.
The entire process took about two hours, and Karumanchi said they could see results within hours.
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In the trial, the protein levels dropped by about 17% in the study individuals after the treatment. Additionally, the lower protein levels correlated with lower blood pressure. Those taking part in the study were able to delay birth for a median of 10 days, double the time for untreated patients.
Karumanchi said the findings are “exciting,” but they’ll need to do more research to make sure it’s a safe and effective treatment.
“We need to do a formal regulatory study … like a standard, controlled trial, where we do treatment versus no treatment,” he explained.
Dr. Yalda Afshar, an associate professor of Obstetrics and Gynecology at UCLA Health, who was not involved with the study, said although the trial was small, it “lays the groundwork” for future research and “flips that script” by targeting the cause of preeclampsia.
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“The really big piece about it … despite being a pilot, is that for the first time, we’re directly removing the disease from that mother,” she told SFGATE by phone; currently, they are forced to “remove the mother from the disease.”
Caitlin Dirvonas, a mother of three from Phoenix, has had preeclampsia during all three pregnancies. Her first child was born at 27 weeks due to severe preeclampsia and remained in the NICU for 75 days. She told SFGATE that a treatment that can help delay a premature delivery even by days could be key.
“Every day at that point, that early on, counts for brain development, for lung development,” she said.
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