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Source: Hospital for Special Surgery Released: Mon 18-Oct-2004, 11:20 ET
Protective Effects of Heparin in Preventing Miscarriages in Lupus Patients
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Medical News Keywords
LUPUS HEPARIN MISCARRIAGE ANTIPHOSPHOLIPID PREGNANT PREGNANCY OSTEOPOROSIS
IMMUNE
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Researchers at the Hospital for Special Surgery in New York City have
identified a potentially valuable therapeutic pathway for preventing
miscarriages in certain lupus patients.
Newswise — Researchers at the Hospital for Special Surgery (HSS) in New York
City have identified a potentially valuable therapeutic pathway for preventing
miscarriages in certain lupus patients.
Their research on the recurrent pregnancy loss that afflicts systemic lupus
erythematosus patients was published in the October 17, 2004, online edition of
Nature Medicine. The article focuses on antiphospholipid syndrome (APS),
defined by thrombosis and recurrent pregnancy loss in the presence of
antiphospholipid antibodies. Antiphospholipid antibodies occur in about 25
percent of patients with lupus, and explain pregnancy loss in up to 20 percent
of patients with recurrent miscarriages who do not have lupus. The research
suggests that the anticoagulant heparin, a common treatment to prevent
miscarriages in these pregnant patients, works differently than previously
understood.
According to Jane Salmon, MD, Director of the Lupus Registry and Repository for
HSS, anticoagulation treatment is “inconvenient, sometimes painful, expensive
and fraught with potential complications, including hemorrhage and
osteoporosis. “
In a study involving pregnant mice treated with antiphospholipid antibodies
from lupus patients, the investigators found that heparin works not as an
anticoagulant but instead by blocking activation of the complement pathway, a
series of inflammatory proteins that the investigative team previously found to
play an essential role in pregnancy loss and placental injury.
“Our results suggest that the mechanism by which heparin exerts its
beneficial effects is more complicated than simply inhibition of thrombin
generation, and they underscore the potential value of developing and testing
targeted complement inhibitory therapy for patients with APS,” said Salmon.
In lupus, the immune system attacks the body’s own cells and tissue,
especially the skin, joints, blood, heart, lungs and kidneys. It affects 1-1.5
million Americans and is a leading cause of kidney disease, stroke and
cardiovascular disease in young women. Understanding how antiphospholipid
antibodies cause pregnancy loss in APS patients could lead to important
insights into the general mechanisms of miscarriages benefiting non-lupus
patients as well, Salmon added.
The article is available online at http://www.nature.com/nm/.
About HSS
Founded in 1863, the Hospital for Special Surgery is a world leader in
orthopedics, rheumatology and rehabilitation. Ranked No. 1 in the Northeast in
its specialties by U.S. News and World Report, HSS was awarded Magnet
Recognition for Excellence in Nursing Service from the American Nurses
Credentialing Center. A member of the New York-Presbyterian Healthcare System
and an affiliate of Weill Medical college of Cornell University, HSS provides
orthopedic and rheumatologic patient care at New York-Presbyterian Hospital at
New York Weill Cornell Medical Center. All HSS medical staff are on the faculty
of Weill Medical college of Cornell University. Its Research Institute is
internationally recognized as a leader in the investigation of musculoskeletal
and autoimmune diseases. The hospital is located in New York City,
http://www.hss.edu.
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