The protective effects of heparin in preventing miscarriages in lupus patients
New York, NY, October 19, 2004 – 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.
Source: Eurekalert & othersLast reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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