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Hopes rise for screening tests for preeclampsia.(Obstetrics)
PRAGUE -- New insights into the patho-physiologic changes of preeclampsia that occur in the placenta are helping researchers to develop potential early screening tests for the disease using biomarkers in maternal blood, Dr. Wolfgang Holzgreve said at the 20th European Congress of Perinatal Medicine.
The current line of research into the cause of preeclampsia originates from observations that associated the long-term presence of fetal cells and DNA in maternal blood with autoimmune diseases such as scleroderma and conditions such as polymorphic eruptions of pregnancy (Lancet 1998; 352:1898-901). About 8 years ago, Dr. Holzgreve and his colleagues at the University of Basel (Switzerland) began to recognize that the association between microchimerism and maternal disease might extend to preeclampsia and play a role in its pathophysiology.
In Dr. Holzgreve's lab, researchers found many more fetal cells and DNA in the blood of women with preeclampsia than in women with normal pregnancies. Reports from his lab indicated that the elevated levels of free fetal DNA in maternal blood positively correlated with the presence and severity of preeclampsia in mothers in a dose-response-like effect (Am. J. Obstet. Gynecol. 2001;184:414-9).
Similar observations were made regarding the effect of the total amount of free maternal DNA in a pregnant woman's plasma. The total free maternal DNA seemed to be a marker for the amount of damage that preeclampsia causes to the endothelial cells that line the liver and kidneys, as well as the circulatory system, he said.
The first insult to occur in preeclampsia is an invasion of trophoblasts that causes impairment of the spiral arteries and placental changes. The investigators hypothesized that the excess fetal cells and DNA going into the maternal circulation cause leukocyte activation and an "inflammatory-like reaction" in the peripheral endothelial system (Placenta 2005;26:515-26).
Anatomists working with Dr. Holzgreve's group have calculated that about 3 billion mitoses occur in the placenta each day--no cancer in humans has such a high rate of division--and this activity produces about 3.6 g of new syncytium each day from all of the placental cell ...
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Source: HighBeam Research, Hopes rise for screening tests for preeclampsia.(Obstetrics)