There is a disease that only pregnant women can get: preeclampsia. It is responsible for up to 76,000 maternal and 500,000 infant deaths every year, according to the official preeclampsia website.
Though relatively easy to diagnose, there are currently no effective treatments for preeclampsia and no known cause. Characterized by high blood pressure and protein in the urine, preeclampsia is closely related to pregnancy-induced hypertension. If the disease progresses, the only solution is to deliver the baby, no matter how far along in the pregnancy this may occur.
Dr. Steven Graves, of the Department of Chemistry and Biochemistry, has been studying this disease’s symptoms and possible causes since 1983. His focus is on a biological product known as a “digitalis-like factor” which has been implicated in several forms of clinical high blood pressure (or hypertension) including preeclampsia.
“This is a material that the body produces that is really not completely characterized,” Graves said. “This means that we don’t know all of its’ chemical makeup or exactly how it works.”
Graves helped perform a double-blind, placebo controlled, multi-centered clinical trial on 51 pregnant women with severe preeclampsia. Half were administered a placebo, but half were given a compound known as Digibind®. This antibody fragment was predicted to bind to this digitalis-like factor and eliminate its effects.
The study hoped to reduce the need of anti-hypertension medication and to have a beneficial effect on kidney function. It did not meet the first goal, as many women were too far along in the disease and had already received anti-hypertensive medications before enrollment. But the study was able to demonstrate an improvement or preservation of renal function in response to the drug. This is the first clinical trial of a medication in cases of severe preeclampsia that has showed an end organ effect.
The study also hinted at reduced complications for the baby upon delivery, but further work needs to be done in this area to verify this outcome.
“This was a completely unexpected finding,” Graves said. “Yet, even when matched for gestational age at the early delivery of the baby, the infant had fewer problems when their moms received the drug.”
Though Graves has been working on this project since 1983, his work is not nearly over. He and his collaborators will next conduct a study on women with preeclampsia in the earlier stages of pregnancy. He hopes that treatment will prolong pregnancies, resulting in fewer premature deliveries and, therefore, healthier babies. This will also allow him to further explore the possible benefits of the treatment on the baby.
“Because this compound [the digitalis-like factor] is not a protein and present in blood at exceptionally low concentrations, it makes exploring its structure and function much, much more difficult,” Graves said. “All of the clinical trials, human subjects, and human specimens really make this medical research so it differs from what usually goes on in Chemistry and Biochemistry.”