Future "treatment" of pre-e, HELLP

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mrss
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Re : Future "treatment" of pre-e, HELLP

Postby mrss » Mon Aug 23, 2010 10:15 pm

quote:Originally posted by Blythe

Hmm, and wouldn't suppressing the maternal immune system - even if possible - be pretty bad in and of itself? I'm thinking of HIV...

The thought of having my immune system suppressed during pregnancy is horrifying. The steroid shots I had last time to help DS's lungs mature really did a number on my body. The best guess is that my immune system was already inadequate from being pregnant, having pre-e and possibly another autoimmune disorder (that we have yet to determine) and the steroids just threw me over the edge. They allowed a dormant virus to run roughshod over my body--most likely an HPV, but the MFM said he's also seen the chicken pox virus do similar things in pregnancy. I was "fortunate" that the only major area the virus chose to attack were the motor nerves for my right arm and I lost motor function until the nerves grew back (about 6 weeks or so). The damage started within two days of the shots. Within another 18 months, however, I had fullblown cervical dysplasia again after being in remission for 12 years. I suppose the virus could have attacked any other part of me as well. Fear of steroid shots follows me throughout this current pregnancy.

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Re : Future "treatment" of pre-e, HELLP

Postby atvlady » Mon Aug 23, 2010 08:52 pm

jenprzygoda, I hate that too when people tell me you won't get it again or your chances are slim. For me, I tell myself I will get it so I can stay a step ahead. We are own individual and I try not to look at stats cause they are that, women lumped together and up comes a average of what our risk is.

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Re : Future "treatment" of pre-e, HELLP

Postby jenprzygoda » Mon Aug 23, 2010 08:27 pm

Wow Caryn - as an AP Biology teacher I love your explanation about the evolution of human reproduction with regards to the problem of "well developed baby vs fitting through the birth canal." I think that you really explained it well and did a great job with the idea that women have more "invested" in the offspring than men. Anne, that was really interesting about the immune system "turing itself down" during implantation. When you think about it, I am always amazed that our bodies allow our babies to even take up residence in the uterus. What always really gets me is that people don't understand when you say that there is no known cause. In thinking about having another child (which I can't even bring myself to think about ever being pregnant again) people always want to make me feel better and say "Don't worry, they will watch you closely and make sure that you don't get HELLP next time." We really are an anomaly to others who have never had PE. Thanks for (everyone who is a member of the PF) being the most amazing women to grace this earth! While we all want there to be a cure (and a cause) we know that we may never know "why" we got this particular complication. Hey, at least we are all in this together!

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Re : Future "treatment" of pre-e, HELLP

Postby atvlady » Mon Aug 23, 2010 00:25 am

Thanks Anne! That was easy to understand. For me I have no obvious reason for my very early onset of pre-e and HELLP. It has left me confused and restless. Is it out of the ordinary for one to test positive for a clotthing disorder while pregnant then outside of pregnancy negative?

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Re : Future "treatment" of pre-e, HELLP

Postby annegarrett » Sun Aug 22, 2010 08:20 pm

I can't speak re: preeclampsia but as someone who lives with an autoimmune disease, I do know that my body is in hyper-defense mode--it overreacts to the slightest germ, virus, or cut. The steroids that I COULD use to "turn down" the heat of my immune system would leave me vulnerable to any opportunistic infection, so Heather is right...it's a balancing act.

One thing that is interesting to note is in "normal" pregnancies, the maternal immune system turns itself down moderately to allow for implantation--and it appears in preeclampsia it does not turn itself down and this prevents proper implantation. I'm oversimplifying, but I am sure Caryn can clarify if that is confusing.

What is confusing to me is that from my conversations with experts and with patients over the past fifteen years that preeclampsia has been too much a part of my life...is that some of us (like me) have super big babies who are like flowers that get overfertilized and have late onset PE; while other women have very small babies and early onset.

The "disease" is more of a constellation of symptions--so as there is not one type of preeclampsia--there won't be one cure or treatment...

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Re : Future "treatment" of pre-e, HELLP

Postby blythe » Sun Aug 22, 2010 09:36 am

Hmm, and wouldn't suppressing the maternal immune system - even if possible - be pretty bad in and of itself? I'm thinking of HIV...

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Re : Future "treatment" of pre-e, HELLP

Postby atvlady » Sat Aug 21, 2010 07:51 pm

Gotcha Caryn, and thanks! That is interesting though but it goes to show you we still have a LONG way to go before researchers figure out how to deal with this stuff, if it will ever be.

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caryn
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Re : Future "treatment" of pre-e, HELLP

Postby caryn » Sat Aug 21, 2010 04:02 pm

Yeah -- it generally doesn't work. That's for a couple of reasons.

One is that they would have to mess with it right at implantation, before we knew we were pregnant.

One is that this KIR/HLA-C stuff (when that's what's going on) is entirely new, and genetic. So there are no preexisting ways to mess with it.

One is that the known ways to tweak immune response, like steroids, don't work once symptoms hit, probably because that is only affecting one small part of the immune response.

One is that there's some reason to suspect that our immune response might not be strong *enough*, at least in some respects. The maternal coordination with the paternal cells seems to be lacking oomph.

And one is that implantation requires a robust immune response, and if part of that response is shut down no one has the faintest idea how the placenta might go on to develop. Sometimes placental cells are incredibly aggressive and invade not just the uterine lining, but also the uterine muscle, and they can even grow beyond that into the kidneys and such. That's a particularly nasty kind of cancer called "trophoblastic cancer" and the last thing they want to do is trigger immediate cancer in all of us.

It's a heck of a problem.

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Re : Future "treatment" of pre-e, HELLP

Postby atvlady » Sat Aug 21, 2010 12:00 am

Then what about some type of immune suppresant in women like me who have no "real" cause other then assumptions? I mean, there is a fine balance between what is safe for the baby but setting the baby aside, has there been any research on immune suppresing?

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Re : Future "treatment" of pre-e, HELLP

Postby caryn » Fri Aug 20, 2010 11:12 pm

At this point preeclampsia is almost defined as an immune response. The question is what triggers it. It looks like different things trigger it in different women -- different underlying susceptibilities -- but inevitably the immune response is involved.

For fun, go to PubMed and type "preeclampsia immune review" into the searchbox. :)


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