WOMEN'S HEALTH
February 19, 2009

Predicting Preeclampsia

A simple urine test appears to predict which pregnant women are likely to go on to develop preeclampsia, the potentially fatal...
New research, presented at the Society for Maternal Fetal Medicine last month, suggests that misfolded proteins excreted in the urine may be the key to understanding and predicting preeclampsia — a condition that causes potentially fatal hypertension during pregnancy. Preeclampsia takes the lives of approximately 76,000 women worldwide every year, and is the number one cause of preterm birth.

The team found that the women who went on to develop preeclampsia indeed had misfolded proteins in their urine.

Irina Buhimschi and her colleagues at Yale University analyzed the urine of 111 women for misshapen proteins several weeks before it would have been possible to diagnose preeclampsia clinically. Normally, proteins fold themselves into a three-dimensional shape based upon amino acid sequence; the protein's function is largely determined by the finished three-dimensional structure. If errors occur in the folding process, however, one protein may be shaped — and therefore behave — like one of a different underlying amino acid sequence.

The team found that the women who went on to develop preeclampsia indeed had misfolded proteins in their urine. This was evident from a simple dye test the researchers had developed: the dye selectively stuck to misfolded proteins. Buhimschi underlines that the "urine dye test is a rapid and non-invasive test that can be used to definitively diagnose preeclampsia."

Now that it seems that proteins may be the key to understanding preeclampsia, Buhimschi says that it may also be possible to develop a treatment for the disease. "This novel identification of preeclampsia as a disorder of protein misfolding opens a door for researchers that may lead to testing of new drugs or developing new therapies." As it stands, the only known "cure" for preeclampsia is delivery.

Buhimschi plans to devote future research to understanding exactly how the misfolded proteins manifest in the symptoms of preeclampsia, and whether "the different shapes employed by the misfolded proteins in preeclampsia are linked to specific clinical symptoms."

The current findings certainly give new hope to treatment of a disease that has frustrated medical professional for decades, and led to many thousands of maternal deaths.
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