Preeclampsia is a serious pregnancy complication characterized by high blood pressure, severe headaches, confusion, swelling, abdominal pain, and high protein in patients’ urine. If the condition is left untreated, it can escalate into life-threatening conditions for both mother and baby, including seizures, organ failure, placental abruption, and hemorrhage.
Preeclampsia affects up to eight percent of pregnant people worldwide. There is currently no guaranteed way to prevent preeclampsia, though some treatments are available. Unfortunately, the current definitive treatment is delivery of the placenta, often forcing very premature birth. But a new study published April 27 in Nature Medicine suggests an innovative possibility for treatment: filtering a specific protein out of a pregnant person’s blood. Read on for an overview of the study, which involved 16 women with early preeclampsia.
What Causes Preeclampsia?
The exact causes of preeclampsia aren’t known, although there are several risk factors. Those include pre-existing conditions such as hypertension or diabetes, as well as a family history of the condition. However, previous research into a protein called soluble Flt-1, which is produced naturally by the placenta, could provide an explanation. These findings have suggested that soluble Flt-1 may be a potential indicator of preeclampsia; in fact, some people with preeclampsia have Flt-1 levels up to five times those seen in pregnancies without it.
The new research, published in Nature Medicine, was led by Ravi Thadhani, a nephrologist at Cedars-Sinai Health System in Los Angeles, and his colleague S. Ananth Karumanchi. They knew that soluble Flt-1 plays an important role in the development of preeclampsia, helping regulate the growth of placental blood vessels, but that people with preeclampsia often have elevated levels of soluble Flt-1. So they wondered: Could removing soluble Flt-1 from the mothers’ blood improve preeclampsia symptoms?
Reduced Flt-1 Stabilizes Preeclampsia Patients
For the new study, Thadhani, Karumanchi, and their colleagues devised a unique, minimally invasive way to “selectively deplete,” or extract, excess Flt-1 from people’s blood. The team constructed an antibody that “grabs” the protein; that antibody was then added to a filter. Next, the research team used an external machine to route each patient’s blood through the filter. Finally, the blood was returned to each patient’s body with excess Flt-1 extracted.
The team first tested the technique in baboons and healthy, nonpregnant people. Once the technique was proven safe and effective, the team tested it in 16 women with early preeclampsia. Per the study abstract, each treatment reduced Flt-1 levels in the blood by about 17 percent. The treatment also seemed to stabilize the physical effects of preeclampsia, decreasing both blood pressure and protein in the urine, two signs of the condition.
Does Flt-1 Have Promise from a Treatment Development Standpoint?
Given the small sample size used in the study, Thadhani, Karumanchi, and their colleagues still have a long way to go before this procedure can be considered on a larger scale. Larger studies are necessary to address the treatment’s safety and effectiveness. Researchers may also need to monitor long-term health outcomes in both mothers and babies involved in the study. However, the initial study does validate Flt-1 as an actionable target in preeclampsia. That alone suggests that the technique has the potential to improve disease physiology and potentially prevent preterm birth.
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While the initial trial was small, further research into Flt-1 could dramatically improve outcomes for both expectant mothers and their babies. Given the lack of effective interventions for this potentially fatal condition, the potential impact on treatment development is profound.
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