An anti-malaria drug combination might be useful in helping to prevent pregnancy complications in women with lupus and the related disorder antiphospholipid syndrome, Yale School of Medicine researchers have found in a new study published in the American Journal of Reproductive Immunology.
Circulating antibodies called antiphospholipid antibodies are normally produced by the body to recognize and attack bacteria and other microbe. In those with lupus and/or antiphospholipid syndrome, however, these antibodies recognize and attack the body's own proteins, putting women at high risk for recurrent pregnancy loss and late gestational complications, such as preeclampsia.
Patients with lupus or antiphospholipid syndrome are often treated with the anti-malarial drug hydroxychloroquine. While the drug can be safely continued during pregnancy, it was unknown whether it might be beneficial in preventing pregnancy complications in women with lupus and/or antiphospholipid syndrome.
In this new study, senior author Vikki M. Abrahams, associate professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale, and first author and Yale medical student Caroline Albert explored whether the drug could treat obstetrical antiphospholipid syndrome.
Abrahams and Albert used a lab-based system to measure the detrimental effects of antiphospholipid antibodies on human placental trophoblast cell function.
"We found that hydroxychloroquine partially reversed some, but not all, of the detrimental effects of antiphospholipid antibodies on human placental cell function," said Abrahams. "So perhaps some form of combination therapy that includes hydroxychloroquine may be beneficial to pregnant patients with lupus and/or antiphospholipid syndrome."
Other authors on the study include William J. Schlesinger, Chez A. Viall, Melissa J. Mulla, Jan J. Brosens, and Lawrence W. Chamley.
The study was funded by grants from the Lupus Foundation of America and the March of Dimes. Caroline Albert was supported by the 2012 Lupus Foundation of America Gina M. Finzi Memorial Student Summer Fellowship.
Citation: American Journal of Reproductive Immunology (Jan. 2014)