Most maternal deaths in the US are preventable, the Centers of Disease Control and Prevention (CDC) reports. And yet, according to recent statistics, they continue to increase. In fact, 2021 was one of the worst years for maternal death in the country’s history, with 32.9 maternal deaths per 100,000 live births — a 40 percent increase from 2020, NPR notes, and more than ten times the rates of other high-income countries. While a number of factors are driving the crisis, data shows that the leading cause of Black maternal death is a disorder called preeclampsia, which can cause high blood pressure, organ damage, and, if left untreated, potentially fatal complications. A root cause and treatment for preeclampsia have long eluded doctors, but a promising new study might reveal potential answers for both.
In the study, published earlier this month in Nature Communications, researchers from Brown and Western Universities were able to identify a protein, cis P-tau, that they’re calling a “crucial culprit and biomarker” for the disorder. Found the both the blood and placenta of preeclampsia patients, cis P-tau “can be used for early diagnosis of the complication and is a crucial therapeutic target,” said Surendra Sharma, MD, PhD, a lead author on the study and professor of pediatrics at Brown, in an interview with Western News.
As it turns out, cis P-tau is also associated with neurological diseases, including Alzheimer’s disease and stroke. Xiao Zhen Zhou, MD, another lead author on the study and associate professor at Western, developed an antibody to target the protein in 2012. That treatment is currently in clinical trials for human patients with Alzheimer’s and traumatic brain injuries.
When the researchers on the current study tested the same antibody in mice with preeclampsia, the results were promising. The antibody therapy “efficiently depleted the toxic protein in the blood and placenta,” Dr. Sharma said, “and corrected all features associated with preeclampsia in mice.” All the typical symptoms of preeclampsia, he explained — including high blood pressure, protein in urine, and fetal growth restriction — “were eliminated and pregnancy was normal.”
Though the therapy has yet to be tested on humans, it still represents quite a breakthrough in a disorder that disproportionately affects Black and Hispanic pregnant people. The researchers remarked upon the notable link it suggests between preeclampsia and brain health, and also mentioned stress as a potential factor in the onset of preeclampsia. (The enzyme Pin1 plays a role in keeping proteins healthy during stress, and when it becomes inactivated, it can transform the tau protein into the toxic variant cis P-tau.)
Notably, this research isn’t the first step forward in preeclampsia news this year. It comes just a few months after the FDA approved a preeclampsia screening test that could aid in early diagnosis.
The US mortality crisis is worsening, and will require a multi-pronged approach to address it and improve outcomes, especially when it comes to pregnant people of color, who are disproportionately affected. It comes down to not just important research, but also increasing availability of health resources and support systems. That includes for mental health conditions, which the CDC has identified as the leading cause of pregnancy-related death in the US. Still, research like this and the spotlight it puts on preeclampsia can only represent a step forward in diagnosing and treating this serious and life-threatening pregnancy complication.
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