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Effect of Antiphospholipid Antibodies on Trophoblast Function in Pregnancy

Abrahams, Vikki M., PhD

Yale University

Antiphospholipid syndrome is a condition in which the immune system produces antibodies against proteins that bind to phospholipids, a fatty substance in cell membranes. This makes blood stickier than normal, increasing the risk of blood clots. Antiphospholipid syndrome can be primary, existing on its own, or secondary to another autoimmune condition, particularly lupus. Women with either primary or secondary antiphospholipid syndrome not only have a high risk of blood clots and stroke, but also of miscarriage and pregnancy-related complications such as preeclampsia and preterm labor. 

Part of the problem during pregnancy is that antiphospholipid antibodies appear to target the cells of the developing placenta, called the trophoblast. This disrupts the cells’ normal function, causing inflammation and cell death where the placenta attaches to the woman’s uterus. These changes, in turn, affect the development of the placenta, preventing its attachment to the uterus, and change maternal blood vessels that connect with the placenta. This, of course, results in significant problems with the pregnancy. 

With this grant, Dr. Abrahams and her team plan to study the impact of antiphospholipid antibodies on trophoblast function and survival, as well as how the trophoblast interacts with the mother’s blood vessels. Their findings will advance our understanding of the underlying mechanisms behind recurrent pregnancy loss and pregnancy complications such as preeclampsia and preterm deliveries in women with antiphospholipid syndrome.

What this study means for women with lupus: While women with APS are at high risk for pregnancy loss and pregnancy complications, it is currently impossible to predict which APS patients will have an adverse pregnancy event. The overall goal of this research is to develop better ways of diagnosing potential problems and to find new treatments to improve the long-term health of the mother and fetus. 

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