Protein May Predict Preeclampsia in First Trimester
Researchers have identified a protein, isthmin 2, that appears to predict preeclampsia and fetal growth restriction from blood samples taken in the first
A protein called isthmin 2 could serve as a first-trimester predictor for preeclampsia and fetal growth restriction. This finding comes from a large-scale screening study published in Nature Medicine, as discussed on the TTHealthWatch podcast.
Researchers analyzed blood samples from thousands of women in the Pregnancy Outcome Prediction Study. They screened for 2,904 proteins and found low levels of isthmin 2 in the first trimester were associated with the subsequent development of preeclampsia or fetal growth restriction. The study's hosts, Elizabeth Tracey and Dr. Rick Lange, noted the protein helps anchor the embryo to the uterus.
Study Validation and Scope
The association was validated in two independent cohorts: the Pregnancy Outcome Prediction Study 2 and the Improving Maternal Pregnancy And Child ouTcomes study. The research aimed to find an early, reliable marker for these serious pregnancy complications, which are major contributors to maternal and infant morbidity.
Gene Therapy for Heart Condition
The podcast also covered a gene-silencing therapy for a specific heart condition. The therapy targets transthyretin amyloid cardiomyopathy, a condition caused by misfolded proteins accumulating in the heart muscle, particularly in older individuals.
An analysis of two studies involving over 2,000 patients found the gene-silencing treatment reduced the primary endpoint-a combination of all-cause mortality and recurrent cardiovascular events-by about 20%. It also improved symptoms and increased the distance patients could walk in six minutes.
Treatment Options and Screening
Dr. Lange explained there are two main therapeutic approaches: protein-stabilizing therapy and gene-silencing therapy. The analysis found no significant incremental benefit from combining the two treatments. The current recommendation is to try one of the two, but not both together, though an ongoing trial is testing that hypothesis directly.
When asked if this warranted broader screening, Dr. Lange noted that while diagnostic tools have improved, making the condition more recognizable, there is no good screening available for the general population due to its relative rarity. He emphasized the need for earlier suspicion to lead to earlier therapy, as the condition is often discovered in advanced stages.
Vaccine Efficacy Review
Earlier in the episode, the hosts reviewed a report from the American Medical Association's Vaccine Integrity Project on respiratory virus vaccines. The project surveyed existing literature to provide evidence-based data on COVID-19, influenza, and RSV vaccines.
For COVID-19 vaccines, efficacy against hospitalization for adults ranged from about 20% to 55% based on the previous year's data. Maternal vaccination led to a 60% reduction in COVID-related medical encounters during pregnancy and reduced hospital encounters for infants in their first year.
Influenza vaccine efficacy ranged from 19% to 43%, with one study showing vaccination during pregnancy reduced the risk of symptomatic disease in infants by over 44%. For RSV, maternal vaccination reduced infant hospitalization with an efficacy ranging from 51% to 70%. The podcast hosts endorsed the AMA's effort to provide trustworthy information in a contentious space.
