Mayo Clinic Researchers Discover Link

Mayo Clinic Researchers Discover Link between High Levels of HtrA1 Protein and Preeclampsia, a Complication of Pregnancy [1]

Mayo clinic Researchers have established a link between protein HtrA1 and preeclampsia, a pregnancy disorder resulting in premature deliveries and maternal-Fetal disability or death. Preeclampsia affects approximately 8% pregnancies and causes up to 76000 maternal deaths worldwide.

This pioneer work will be presented at the Society for Maternal-Fetal Medicine annual meeting in Miami.

Significance of the Mayo Clinic Research

The first predictive test for preeclampsia might originate from this nascent research.

Research comprised two steps:

Measurement and comparison of the HtrA1 level from the 30 placentas of preeclamptic patients and normal deliveries each were carried out by gestational stage. Diabetic and other patients with variable blood pressure were excluded in the study.

Noting higher HtrA1 level in the placenta of preeclamptic patients thus developing a possible blood test to determine preeclampsia.

Background Biology

Before this research HtrA1 was known to be connected with systematic cell destruction, alteration and "invasiveness" i.e. invasion and colonization as in case of cancer. The positive aspect of invasiveness is in placental growth in uterus during the first trimester.

According to research the HtrA1 hamper the cytotrophoblasts' proper functioning whose job is placental formation in uterus; the mechanism is unclear but one possibility is due to their similar molecular structure as insulin-like growth factors (IGF) binding proteins, they fit and initiate abnormal growth causing dysfunction of placenta and hampered fetal growth.

Discussion

It is estimated that about 8% of the pregnancies are effected and staggering 76000 maternal deaths are caused by preeclampsia the world over each year. The questions these figures arise are:

what is preeclampsia?

A what causes it and how?

A and what are the preventive measures and remedies?

Preeclampsia[2][3] is a serious complication occuring during pregnancy and causes rise in blood pressure and in some cases accompanied by swelling of hands and mouth. Many end up in premature delivery and in severe cases disablilty or even death for mother and fetus. Answer to the second question is uncertain at the moment but the research undertaken in this regard and especially by the researchers of Mayo clinic, is proving to be promising and may auger well in establishing the cause and mechanism of the said disorder. This pioneer research is based upon the hypothesis that protein HtrA1 might be linked with the preeclampsia. In view of this premise they carried out experiments to determine the pathological reasons of preeclampsia.

In order to correlate the level of the HtrA1 protein with preeclampsia the team of researchers which included Brian Brost, M.D., Funminiyi Ajayi, M.D., Jeremy Chien, Ph.D., Thomas Gaffey, M.D., William Watson, M.D. tested and monitored the levels of HtrA1 in the certain cells of placentas taken from the women known to be suffering from preeclampsia, then this data and statistics acquired were collated with the data from the placentas of normal deliveries. The number of placentas analysed was thirty each from the preeclamptic patients and normal deliveries. The analysis was done in pairs, of healthy and preeclamptic placentas and by gestatational stage. In accordance with the standards set by the American College of Obstetricians and Gynecologists the placentas were grouped as "normal," "mild preeclampsia" and "severe preeclampsia," on the basis of recorded blood pressure of their mothers. There were certain well defined controls and parameters also placed like making sure those patients with diabetic and other disease histories that might affect blood pressure were not included in the experiment, the purpose was to study the causative agent of preeclampsia alone. The records showed that the significant amount of HtrA1 is present in the placental tissues of women with severe preeclampsia. In the light of this latest discovery it is hoped that this might lead to some sort of predictive test, which hitherto before did not exist for the early determination of preeclampsia. It is expected that this test will serve as early warning sign of preeclampsia and would permit the medical professionals to cope with the disease on non-crisis basis and possibly divert the situation in which the threat is posed to the life of mother and fetus, by governing more cautious approach entailing therapies and other procedures that might altogether stop it from materializing. In keeping with the same premise that HtrA1 protein is linked with preeclampsia the next thing that needs to be determined is how exactly the whole mechanism is brought about, the possibility explained in this regard is also open to criticism and improvement. According to this because of their similar molecular structure as insulin-like growth factors (IGF) binding proteins, the HtrA1 protein fits in the placental sites and adversely affects the activities of cytotrophoblasts and thus leads to the defective placenta and fetus abnormality.