0
0
Pre-eclampsia, a dangerous increase in blood pressure during pregnancy, remains an enigmatic disorder, resulting in the deaths of over 70,000 women globally annually. The absence of a clear understanding regarding its underlying causes has led to a lack of precise treatment approaches. Contrary to common belief, delivery, though the sole existing intervention, does not equate to a remedy. Vesna D. Garovic, M.D., Ph.D., a nephrologist at Mayo Clinic in Rochester, Minnesota, has dedicated her professional journey to investigating this prevalent complication of pregnancy.
“Even following childbirth, women can experience persistently high blood pressure for extended periods, spanning days to weeks,” she explains. “Furthermore, they continue to face an elevated susceptibility to cardiovascular and kidney diseases even decades later.”
Through a combination of laboratory experiments and epidemiological investigations, Dr. Garovic has demonstrated that women affected by pre-eclampsia undergo an accelerated aging process, predisposing them to age-related ailments like heart attacks, strokes, and kidney failures.
Her research is unraveling a potential mechanism underlying pre-eclampsia, potentially paving the way for the development of the first therapeutics targeting the root cause of the condition. Moreover, it emphasizes the significance of heightened screening and medical intervention for women with a history of pre-eclampsia.
While most pre-eclampsia research has been grounded in the notion that the condition originates within the placenta—an organ that emerges during pregnancy to safeguard and nourish the developing fetus—Dr. Garovic’s work is shedding light on an alternative perspective.
In cases of pre-eclampsia, scientists theorize that the placenta releases certain molecules into the maternal circulatory system, triggering inflammation and disrupting the process of forming new blood vessels, a crucial step known as angiogenesis. This is believed to lead to systemic health issues in the pregnant individual.
The primary objective has been to pinpoint the specific molecule or molecules accountable for this process, as explained by Dr. Garovic. Over the course of many years, researchers had observed that placentas from pre-eclamptic pregnancies exhibited signs of accelerated aging in comparison to placentas from uncomplicated pregnancies. Dr. Garovic highlights, “However, it seemed paradoxical to label pre-eclampsia as a condition of aging when studying individuals who are only 25 years old.”
Interestingly, a significant number of the molecules found at elevated levels in pregnancies affected by pre-eclampsia were established indicators of senescence, a cellular condition that directly signifies “the progression of aging.”
Dr. Garovic proposed a hypothesis that senescence might serve as the route through which certain women experience the development of pre-eclampsia. Senescent cells cease to divide, yet they don’t undergo cell death and are not consistently expelled from the body. Instead, they occasionally amass within tissues and release detrimental molecules.
Using data and samples from the Rochester Epidemiology Project, Dr. Garovic has meticulously monitored signs of aging and senescence in women who experienced pre-eclamptic pregnancies and those who didn’t. Collaborating with Mayo Clinic obstetrician-gynecologists Wendy White, MD, and Yvonne Butler Tobah, MD, they discovered that women with a history of pre-eclampsia tend to develop a higher number of chronic conditions later in life, and these conditions manifest at an earlier age compared to those without a pre-eclampsia history.
Working alongside Mayo Clinic’s experts in cellular senescence, James Kirkland, MD, PhD, and Tamara Tchkonia, PhD, they also established that women with pre-eclampsia undergo a process of accelerated aging during pregnancy, as evidenced by changes in the “epigenetic clock.” This clock gauges biological aging by measuring the accumulation of methyl tags at various genomic sites, which shift over time in an organism.
Their investigation unveiled that women with pre-eclampsia aged, on average, 2.4 years more rapidly than those without pregnancy complications during their pregnancies and at the time of delivery.
Dr. Garovic envisions a future where emerging medications in the field of senescence could potentially be deemed safe for use during pregnancy, offering additional options for women at risk. Even in the absence of present treatments aimed at targeting senescent cells in women with a pre-eclampsia history, she remains confident that research on the connections between this pregnancy complication and future health outcomes will yield substantial benefits.
Her studies, in combination with others, are already leading to fresh guidelines for the screening and management of women at risk, ultimately aiming to enhance outcomes and preserve lives. As an example, Dr. Garovic played a role in an American Heart Association working group focusing on hypertension during pregnancy and contributed to the association’s scientific statement, which underscored the need for further efforts to safeguard women from the complications of hypertensive pregnancies and potential post-pregnancy repercussions.
“For women who have had pre-eclampsia, their blood pressure needs to be monitored, their cholesterol needs to be checked, their kidney function needs to be followed,” she emphasizes. “We need to keep track of their BMI and weight and try to manage lifestyle modifications and their health long-term.”
Source ANI
