Scientists find cause of preeclampsia?

[ktsl123]

http://www.guardian.co.uk/science/2010/ ... root-cause

[l412angel]

Im like speachless...so what I am getting from this article is that taking ACE inhibitors can ward off PE? And to take them ever before PE?

[angieb]

I hope Caryn comes by to maybe explain this a little more, because I'm confused!

If oxidents are the issue, shouldn't the antioxident trials have worked?

[l412angel]

yah im kinda lost here too!

[tree]

I downloaded the paper from Nature, and it looks quite interesting. It is very far outside of my field, so I don't understand much of it. They did some really cool XRD analysis and matched those results to data from blood samples of pre-eclamptic and normo-tensive women. Their conclusions suggest that the results will enable the development of better screening/monitoring tools for pre-E and guide the development of new anti-oxidant therapies. They don't say anything in the paper about ACE inhibitors, other than to mention that they are currently the standard therapy. Caryn, other experts, email me through my profile if you want the full text. I am sure there are many people here who can provide a better explanation than I have attempted here.

[sam10]

ooops, I meant to add something to my post, but not to delete it...

I read the article again, but I find it a bit confusing what it says about the ACE inhibitors. As far as I know (correct me if I am wrong though), labetalol and nifedapine are not ACE inhibitors?

[blythe]

Hmmm, I think the article was written by a non-science person, or at least a non-pregnancy person. I thought ACE inhibitors were Category D in pregnancy, and therefore not used. Teresa, thanks for the summary! Hopefully Caryn will be along soon to put this in perspective with all the other research out there!

[blythe]

http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm102981.htm

[sam10]

Hi Heather,I found similar web-sites when I googled about ACE inhibitors not being recommended during pregnancy.

[caryn]

Long story short, the Guardian article is jumping the gun a bit! :)

"Root cause" in particular is silly; notice this sentence from the article: Professor Carrell said changes in the placenta during pregnancy alter how much oxygen the growing baby receives, but this can trigger the release of free radicals that oxidise angiotensinogen and cause blood pressure to rise.

So changes in the placenta come first -- and the quoted researcher was careful to point this out. And what they do is trigger biological cascades, one of which makes it much easier to break angiotensinogen -- which is a precursor molecule to some molecules that raise bp -- apart into the molecules that raise bp.

But the sFlt-1 and sEng molecules are actually acting first, and poking the holes in the vasculature that trigger the release of the angiotensinogen.

Re: ACE inhibitors -- the development of the placenta is intertwined with the development of the fetus and the development of blood vasculature. If it alters the course of placental development it can also alter the course of fetal development -- and boom, birth defects. I don't expect anyone to start scripping ACE inhibitors, not if they could block sFlt-1 instead.

I'll have more up after I finish reading the paper and brush up a bit on my redox reactions!