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New molecular discoveries on the topic of preeclampsia - in a joint study by scientists from two faculties at the Technion

Preeclampsia is a life-threatening multisystem disease and one of the main causes of maternal and fetal mortality. Its global prevalence is about 5% of pregnancies

Advanced pregnancy. Illustration:
Advanced pregnancy. Illustration:

Technion researchers present new discoveries concerning preeclampsia. In their estimation, the research findings will advance the treatment of the disease through the development of methods for early and non-invasive diagnosis and a better understanding of the molecular changes associated with preeclampsia. The findings were published in MED, Cell Press' flagship clinical and applied research magazine.

The joint article presents New biomarkers That will make it possible to diagnose early preeclampsia in its pre-symptomatic stage and thus offer a more effective intervention that will save illness and suffering from both the mother and the fetus. The researchers state that they are working to develop targeted scans for the early, non-invasive diagnosis of those biological markers in the maternal blood or in the cervix.

The research was led by doctoral student Inbal Admati and master's student Niv Skarbianskis under the guidance of Dr. Amit Zeizel from the Faculty of Biotechnology and Food Engineering and Prof. Ido Sholt from the Rappaport Faculty of Medicine and the Rambam Medical College. Technion researchers Dr. Hanna Hochgarner and Dr. Asnat Ofir and Prof. Simcha Yegal from Hadassah Hospital participated in the study.

Preeclampsia (preeclampsia) It is a life-threatening multisystem disease and one of the main causes of maternal and fetal mortality. Its global prevalence is about 5% of pregnancies and it is characterized by great variation in its severity and characteristics. In dangerous situations, it may damage the mother's kidneys, liver, brain and other organs. The only treatment today is an early induced birth, the removal of the placenta and the fetus will improve the mother's condition and end the disease. The placenta, which develops during pregnancy, is genetically an organ of the fetus and not of the mother. According to doctoral student Inbal Admati, "This organ invades the mother's body during 'molecular maneuvers' that prevent the mother from rejecting it. The placenta is the oxygen artery of the fetus and it supplies him not only with oxygen but also with all nutrients, immune protection and hormonal resources and removes waste from his body." 

Admati started her doctorate at the Technion during her first pregnancy. One day, about a month and a half before the intended date of birth, she was rushed to the emergency room due to pain and there it was discovered that she was suffering from a severe case of preeclampsia. The medical team rushed to put her under full anesthesia and deliver her in this condition. When she woke up she found that she was the mother of a healthy baby. During her maternity leave, she decided that she did not want to return to the original topic of her doctoral thesis, research on zebra fish, but to start researching the disease that had shaken her life. "It was clear to me that this was not an area that Dr. Zeisel deals with, and I imagined that I would have to find another supervisor, but he suggested that I stay with him and add Prof. Ido Sholt from the Faculty of Medicine as a partner from the clinical side." In a short time, Prof. Sholt became a co-supervisor and Adamati's new doctoral thesis was on track.

The idea was to use the laboratory's central tool, designed for the analysis of gene expression in individual cells, for the analysis of placentas from pregnancies in which preeclampsia developed. "One of the constraints of this method," Admati says, "is that this technology requires fresh tissue, and that's how I sometimes found myself driving in the middle of the night with a cooler full of ice to bring placental tissue from mothers who had just given birth."

The Technion researchers show in their article that preeclampsia is indeed divided into two very different types. One erupts early and is often more dangerous; The other erupts later and will usually be less severe. The existence of these two distinct diseases was already known before, but the current study is the first to map the two diseases at the molecular level and addresses the issue of the heterogeneity of the disease at the single-cell level.

The researchers examined the differences between a placenta from early pregnancy toxicity versus a placenta from premature birth without toxicity, and at the same time a placenta from late pregnancy versus a placenta from a normal pregnancy. Part of the challenge was to understand exactly in which cell types changes occur, since the placenta is a tissue with several dozen cell types. In preeclampsia, the researchers discovered an extensive disruption in the genetic control of all types of cells in the placenta and signs of an inflammatory process originating from overactivity of the immune factors in this organ. According to them, in early toxemia the placenta occupies a central place in the disease processes, while late toxemia is characterized by little involvement of the placenta in inflammatory and other processes.

The study was supported by the Preeclampsia Foundation through a Peter Joseph Pappas research grant.

for the article in the journal MED

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