Developing a test for preeclampsia in first trimester

Preeclampsia, a condition that occurs in as many as seven percent of pregnancies, can prove deadly for both mother and child. In the United States, approximately 10,500 babies die from preeclampsia each year out of an estimated half a million worldwide. Fans of the television show Downton Abbey will remember it as the cause of Lady Sybil’s death, but almost a century later, and despite decades of research, we still don’t fully understand this disease. Researchers at Texas A&M University are working to change that.

Mahua Choudhury, PhD, assistant professor at the Texas A&M Irma Lerma Rangel College of Pharmacy, is working with Gerard L. Coté, who holds the Charles H. and Bettye Barclay Professorship at the Texas A&M University College of Engineering and is director of the Center for Remote Health Technologies and Systems, and Kayla Bayless, PhD, an associate professor at the Texas A&M College of Medicine.

The researchers have identified a number of epigenetic factors affecting gene expression that tend to show up relatively early in the pregnancies of women who ultimately are diagnosed with preeclampsia, which is characterized by high blood pressure and protein in the urine. These factors thus make intriguing potential preeclampsia biomarkers. Choudhury hopes that she can use it to predict which women will get preeclampsia as early as nine weeks into their pregnancies—a vast improvement over the current tests, which don’t show the condition until 22 weeks into pregnancy.

“If we can know early who is likely to experience preeclampsia, we can possibly prevent it,” Choudhury said. “There are potentially nutritional or other interventions that could stop the disease before there are negative consequences for both mother and baby.” Bayless and Choudhury’s group are working together for several mechanistic aspects of these “nutraceutical” (meaning using food as medicine) inventions. “If successful, this can identify a susceptible population of women in time to treat the disease before life-threatening symptoms progress,” Bayless said.

Choudhury wants her test to be available to all women, even those in developing countries who lack money for health care. She received a grant in 2011 from the Bill & Melinda Gates Foundation, which funds innovative global health and development projects, to make the test available almost like a home pregnancy test. The test works by detecting an increase or decrease of expression of several epigenetic factors that might have implications in the development of preeclampsia.

“We envision developing a point-of-care test for detecting the new biomarkers of preeclampsia in a women’s blood or urine that could be very affordable and easy to use,” Coté said. The team is currently gathering additional preliminary data and applying for the necessary funding to progress faster and further.

“Ultimately, we hope that this same technology might be able to test for a multitude of other diseases, just by changing the type of factors on the stick that can detect the biomarker,” Choudhury said. “An extremely inexpensive and easy to administer test would make a major difference in the lives of people in the developing world and elsewhere who lack good access to care.”