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Caryn
Ask the Experienced Moderator
USA
8780 Posts |
 Posted - 10/02/2009 : 7:45:00 PM
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These findings demonstrate that sustained maternal immune system activation via TLR3 during pregnancy causes PE-like symptoms in rats and suggest that viral infection during pregnancy may contribute to the development of PE.
http://www.ncbi.nlm.nih.gov/pubmed/19779466
Catherine works on this stuff. I think basically it's saying that anything that pisses off your immune system in pregnancy pisses off your immune system, and can therefore lead to preeclampsia, which is pretty much *defined* at this point as an ineluctably pissed-off immune system in pregnancy.
Hopefully Catherine will riff on this further. :-)
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Catherine
Director of Research Development
USA
3320 Posts |
Posted - 10/02/2009 : 9:32:13 PM
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Uh... yes I do, in a somewhat peripheral sense.
Um, the disconnect for me here is that TLR3 specifically recognizes double stranded RNA which only occurs in nature in the context of certain (but not all) viruses. The poly I:C administered to the animals in these experiments is a synthetic compound that mimics viral RNA. So immune cells that carry this receptor become activated when the viral ligand sticks to it. Hence the authors' comment that viral infection during pregnancy could trigger preeclampsia.
I'd have thought that someone somewhere has looked quite exhaustively by now for some evidence for an infectious cause or trigger for preeclampsia..... |
Catherine
Mom to Finn, Lucy (preeclampsia and HELLP) and Chloe.
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Edited by - Catherine on 10/02/2009 9:32:36 PM |
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Blythe
Ask the Experienced Moderator
USA
2277 Posts |
Posted - 10/03/2009 : 3:28:57 PM
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I did a quick pubmed search - looks like there's a (small?) correlation, and this current study is looking at possible causal relationships?
http://www.ncbi.nlm.nih.gov/pubmed/18166297
Maternal infection and risk of preeclampsia: systematic review and metaanalysis.
...Urinary tract infection and periodontal disease during pregnancy are associated with an increased risk of preeclampsia. More studies are required to verify this as well as to explore whether or not such relationships are causal and, if so, the mechanisms involved.
http://www.ncbi.nlm.nih.gov/pubmed/17577649
Association between maternal infections and preeclampsia: a systematic review of epidemiologic studies.
CONCLUSIONS: In our analysis, any infection (bacterial or viral) was associated with a two-fold higher risk of preeclampsia. This association may provide a potential explanation for preeclampsia-related inflammation. |
Heather - mom to
DS #1 - 7/18/03, 37 weeks - Mild PE, 5lbs, 8oz, 4 days in NICU
DS #2 - 8/11/06, 36 1/2 weeks, 6lbs, 14oz!!! Induced for diagnostic BP. No NICU!
DD #3 - 9/10/09, high bp at 33 1/2 weeks, induced at 37 weeks, 5 pounds, 12 ounces - healthy girl!
"Thank God for the internet - otherwise my children would be raised in a med school library" |
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jgrumet
Junior Member
486 Posts |
Posted - 10/03/2009 : 11:40:44 PM
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I always thought that even at implantation you have PE, but it doesn't show up until later...is that wrong?
What kind of a viral infection are they talking about? I know a lot of women said they had a bad illness with their PE pregnancy (such as swine flu), could that possibly be the trigger? |
Jamie (22)
Brian (26)
Aram 6/22/2008 born 33 weeks 5 days- HELLP class II
Adopting next baby 2010! |
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my3tatertots
New Member
US
78 Posts |
Posted - 10/23/2009 : 5:25:43 PM
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| That's interesting. I've had PIH/PE twice now but in my second pregnancy I developed it much earlier - 32 weeks vs 40 weeks. I also had a viral infection at 20 weeks with my second pregnancy that was dx'd and treated by my OB. I wonder if the strain on my immune system caused PE to show up earlier. Of course there was at least 10 weeks in between my viral infection and the start of PE so who knows. |
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LisainNJ
Advanced Member
596 Posts |
Posted - 10/28/2009 : 7:57:35 PM
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When I lost Francesca, the hospital had a cluster of three of us with preeclampsia at 20 weeks, one about ten days before and one a day or two later than me.
I was hit with one upper respiratory infection after another in that pregnancy, viral, bacterial sinus, viral - felt constantly sick and inflamed. Sucks that a little thing like that can contribute. |
LisainNJ
wife to Joseph
ds born 1988 (Asperger's syndrome), dd born 1991, ds born 1996, dd born 2002
and my babies in heaven Elizabeth miscarried 2000 d. 13 weeks, Therese miscarried 2001 d. 10 weeks, Francesca Marie, stillborn 9/1/2006, 20 weeks, PE/HELLP |
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bmitchell
Starting Member
US
1 Posts |
Posted - 02/06/2010 : 02:48:39 AM
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| As the senior author of the paper ya'll you are discussing first off I am honored that Caryn and others have commented on our work and findings-this certainly makes a basic scientist feel good that our work may have some real life implications. Secondly, hopefully to clarify, we were able to induce PE-like symptoms in rats by excessively activating the mom's immune system during pregnancy. As Caryn mentioned in somewhat other terms, the mom's immune system is already activated trying to prepare for and accept a half-foreign fetus. This represents a pro-inflammatory state in preparation for these events. What we showed that is that the events associated with pregnancy do not cause PE alone, nor does immune system activation in non-pregnant animals, but the combination of the 2 caused PE like symptoms in animals. Toll-like receptor 3 senses double-stranded RNA (which are rotavirus and rheovirus), but several other factors can activate these receptors during pregnancy. While I would love to prove that every case of PE is caused by previous exposure to rheo/rotavirus, necrotic (dying) cells can also activate TLR3 and other viruses (single stranded RNA viruses such as CMV, HPV, etc. when they divide create double-stranded RNA) can also activate TLR3. We are presently determining whether a mom has to have an active viral infection vs. a latent one as well as whether TLR3 is activated in women with PE vs. normotensive pregnant women. My ultimate goal, if we find that TLR3 is activated in PE women, is to design TLR3 inhibitors as a therapy to prevent PE after it is diagnosed. In support, we have developed a mouse model of the disease, somewhat similar to the rat model in the paper, but we are able to gather a substantial amount more data regarding the possible mechanisms and are now able to test various therapeutics. While it is no consolation to those of you who have experienced PE, hopefully we can treat this in women in the near future. |
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L412Angel
Senior Member
US
1205 Posts |
Posted - 02/06/2010 : 10:13:35 AM
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| I as well had a respratory infection with Cara about a month before I delivered her...hmmm interesting! |
*Laura Angel
(Factor V Leiden & Hyperlipidimia)
Mom to Cara Angel, born still at 30+3 days on 11-17-09 due to Severe PE/HELLP(Class III)
Baby #2 due March 2011
"An Angel in the book of life wrote down my baby's birth. And whispered as she closed the book "too beautiful for earth."
http://onlyangelsmakethelist.blogspot.com/ |
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emmie160
Starting Member
UK
11 Posts |
Posted - 02/06/2010 : 11:33:06 AM
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This is so interesting!!
Three weeks before I was diagnosed I had suspected swine flu. I never felt 'right' after. I long suspected that the flu had triggered off my hellp/pe but my doc said otherwise and thought that my pe only started a few days before I was diagnosed. I, however am convinced the flu set off my syptoms.
Emma |
Emma
Precious angel Richard Joseph silently born 11/09/09 at 24+6 weighing 1lb 4. Sleep tight little man. |
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Caryn
Ask the Experienced Moderator
USA
8780 Posts |
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L412Angel
Senior Member
US
1205 Posts |
Posted - 02/14/2010 : 7:23:38 PM
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| So for next pregnancy would everyone reccomend getting the flu shot? |
*Laura Angel
(Factor V Leiden & Hyperlipidimia)
Mom to Cara Angel, born still at 30+3 days on 11-17-09 due to Severe PE/HELLP(Class III)
Baby #2 due March 2011
"An Angel in the book of life wrote down my baby's birth. And whispered as she closed the book "too beautiful for earth."
http://onlyangelsmakethelist.blogspot.com/ |
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love_the_daschies
Advanced Member
US
858 Posts |
Posted - 02/14/2010 : 11:42:21 PM
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Hmm interesting. Right when I saw the articles I wondered if CMV would increase risk - especially since so many people have CMV and never have any knowledge of it or issues from it (the first study HEather linked says yes it does). I also wonder how EBV infection would play out. I have chronic EBV. I would estimate at LEAST 50% of the organ donors we see have either EBV or CMV come back as positive (these are minor infections and do NOT rule organs out for transplantation.
Laura, I always recommend getting the flu shot :) However, and someone correct me if I am processing this wrong, it seems to me the risk is more from a chronic underlying infection and not an acute illness such as the flu. |
Jamie - 28 - CHTN, asthma
Hubby - 31
Mom to Vincent ~ b/d 4-29-09 @ 22.5 wks due to severe superimposed PE. * I miss you little boy *
Little Lou - 3/30/10 - 4 lbs 11 ounces and 18 inches @ 36 weeks 4 days(GD, superimposed PE)
http://definingme-ramblingsofaneurotic.blogspot.com/
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JMom08
Junior Member
US
462 Posts |
Posted - 02/15/2010 : 12:45:54 PM
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| Hi Laura, if I remember the posts on the main PF page and the advice from my OB right, I think ACOG already recommends all pregnant women get the flu shot. I remember grilling my MFM during my last pregnancy about what I should do if I couldn't find a flu shot without thimerosal (this was in 2005, before swine flu), and he told me that he felt the risks of possible mercury were outweighed by the risks posed getting the flu while pregnant (I did find preservative-free shots for both pregnancies). My guess is that you should ask your doctor(s) to see what they say in your particular case. |
Emily
mom to DS #1, born Feb 2006, 36 weeks - PE, c/s
and DS #2, born June 2010 (protein C deficiency clotting disorder; lovenox, lda) - no PE |
Edited by - JMom08 on 02/15/2010 12:46:24 PM |
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Toll-Like Receptor 3 Activation During Preg.
