12:00 AM
Aug 07, 2014
 |  BC Innovations  |  Cover Story

Dyeing to diagnose preeclampsia

Although there is widespread agreement on the need for a better way to diagnose preeclampsia, few companies have pursued new tests because finding specific markers has been difficult. A Yale-led group has found dye-binding aggregates of misfolded proteins that could be markers for preeclampsia and has developed a simple urine test that can rapidly diagnose the condition.1

The test could speed up treatment for women who have preeclampsia and spare unnecessary procedures in women who do not, but it is not yet clear whether the primary market would be in developed or underdeveloped countries.

Early next year, three members of the team behind the study expect to launch an international trial of an inexpensive version of the test that Yale School of Medicine spinout GestVision Inc. will supply.

Preeclampsia is not uncommon-occurring in about 5% of pregnancies-and can lead to maternal seizures that are life threatening to both mother and fetus. Currently, the only effective treatment is preterm delivery by induced labor or Caesarean section. The standard of care in the U.S. and EU for managing the condition prior to delivery includes antihypertensives to reduce blood pressure, magnesium sulfate to prevent seizures and steroids to promote fetal lung development.

Preeclampsia is usually diagnosed in the second or third trimester when clinical symptoms of hypertension and proteinuria appear. But those measures are of limited help because high blood pressure can be caused by other conditions and preeclampsia can occur without significant proteinuria-referred to as atypical preeclampsia.

As a result, a common outcome of a preeclampsia diagnosis is that the patient is watched closely to see if symptoms worsen, which can delay treatment decisions for several weeks or more.

"There is a need for a preeclampsia diagnostic that is not based on subjective assessments of blood pressure and proteinuria but instead is based on objective biochemical markers," study leader Irina Buhimschi told SciBX.

In 2008, Buhimschi led a study that found proteins in urine from patients with preeclampsia that were not present in urine from women who had uneventful pregnancies or other conditions that cause proteinuria.2 The study was the first to identify proteins that could distinguish proteinuria caused by preeclampsia from other causes of high protein in the urine.

In the same study, her team also showed that urine and placentas from women with preeclampsia contained oligomeric aggregates that had misfolded protein fragments of the protease inhibitor α1-antitrypsin (AAT; A1AT; SERPINA1).3

That suggested to Buhimschi and colleagues that preeclampsia could involve multiple oligomers of misfolded proteins-known generically as amyloids. Moreover, their presence in urine could provide an accessible diagnostic marker for the condition.

In the new study, Buhimschi teamed...

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