Why is pregnancy loss more common for women with lupus? The answer may come from a seemingly unrelated finding started 10 years ago by noted researcher Betty Diamond, MD at The Feinstein Institute for Medical Research. Dr. Diamond is applying her initial LRI-funded discovery of an autoantibody that attacks the brain to provide a new biological explanation of pregnancy loss in lupus.
Auto-antibodies May Be Responsible
The groundwork for Dr. Diamond’s latest study, which is funded by the National Institutes of Health, was laid by an innovative research finding sponsored almost 10 years ago by the Lupus Research Institute. In the original LRI-funded project, Dr. Diamond discovered that certain auto-antibodies, which trigger the kidney and related physical complications of lupus, are likely also responsible for lupus patients’ neurological, or brain, changes, which range from headaches and memory problems to seizures and stroke. She and her colleagues have designed an experimental drug to neutralize these auto-antibodies. If this drug proves safe in animal studies, clinical studies will then look at its effectiveness in lupus patients.
Continuing to build on her findings, Dr. Diamond went on to show that these auto-antibodies can cross the placenta and harm the brain of the fetus. According to Dr. Diamond, this subset of auto-antibodies which cause miscarriage in mouse experiments occurs in about 40% of patients with lupus.
Her latest study with pregnant lab mice with a lupus-like disease, revealed that these auto-antibodies triggered the loss of more female than male fetuses.
These findings, reported in the May 2012 issue of the Journal of Experimental Medicine, may help explain reports of births of more boys than girls to women with lupus, she said. The reason for this gender bias could not be determined but the study provides clues for further exploration.
It is very encouraging that Dr. Diamond’s fundamental discoveries show promise in developing new treatment approaches to reduce the risk of pregnancy loss for women with lupus.
For now, however, Dr. Diamond emphasized that the findings should not worry women with lupus who are pregnant or want to have a child. “Every woman, not just those with lupus, takes a risk when she becomes pregnant,” she explained. “For women with lupus, there is some increased risk for fetal loss and complications. However, I don’t discourage my lupus patients from becoming pregnant.”
Most Women with Lupus Have Successful Pregnancies
Recognized expert in lupus pregnancy Jane E. Salmon, M.D., of the Hospital for Special Surgery in New York echoes Dr. Diamond’s reassurance to women with lupus that pregnancy is often safe and successful. A study reported by Drs. Salmon and Buyon last year at the American College of Rheumatology Annual Scientific Meeting found that most women with stable lupus have successful pregnancies and healthy babies.
“Our findings showed that women with lupus whose disease is not active and who may be taking low dosages of prednisone are likely to have uncomplicated pregnancies.
“Dr. Diamond’s work is so important as pregnancy is a very real issue for women with lupus, said Margaret Dowd, President and CEO of LRI. “But also exciting is how this research demonstrates the progression of the science, from a novel, out-of-the-box idea through new drug development. We are very proud of Dr. Diamond for her achievement in following her scientific vision over the past decade, and we are proud of the LRI for providing the funding to help realize that vision into reality.”