A Rosy Outlook for Pregnancy & Lupus

Article Source: http://www.medscape.com/viewarticle/878764

sle_lupus_research_plasma_autoimmune_pregnancy.jpg

There was a time when women diagnosed with lupus were cautioned against getting pregnant; the combination of lupus and pregnancy was thought to be too dangerous for mother and child. However, research by Jane Salmon, MD, a rheumatologist at the Hospital for Special Surgery (HSS) in New York City, is now helping change this belief. By carefully risk-stratifying patients on the basis of clinical and biological markers, it seems that the vast majority of pregnant patients with lupus can be assured that their pregnancies will be uncomplicated. Medscape recently spoke to Dr Salmon about her work.

Medscape: Tell us a little about how you began studying pregnancy and lupus.

Dr Salmon: Patients with lupus tend to be young women in their reproductive years. Lupus generally presents between age 20 and 40 years, and 90% of the patients are women. Some of the first questions they often ask when they receive their diagnosis are, “Can I have children?” “Will my pregnancy be safe?” and “Will my children have lupus?”

In the 1980s, when I was training in rheumatology, the feeling was that pregnancy in lupus was dangerous. This wasn’t based on strong evidence, but on the rational concept that because lupus tends to be a disease of women, hormones may play a role in disease pathogenesis, and pregnancy is a state with high levels of female hormones (ie, estrogens, progesterone). Thus, it was anticipated that patients with lupus who become pregnant would have severe flares. And in fact, patients who become pregnant when their disease is active and not well-controlled often develop even more severe organ dysfunction. So there was clinical basis for the anxiety among the physicians, but perhaps it was applied too broadly.

Medscape: How has your research helped changed this way of thinking?

Dr Salmon: Patients asked for and deserve data around such an important question. They wanted the evidence that, in fact, this was true. And we wanted to identify the predictors of poor pregnancy outcomes and the mechanisms that caused damage to the placenta and the developing baby.

What, Me Donate Plasma for Research?

The reasons are fairly obvious and straightforward. Research undertaken in the past by committed and forward-thinking people has given us a standard of living and life expectancies that would have been unimaginable not that long ago. It’s easy to take all of this for granted. Treatments for diseases that were deadly and intractable didn’t come out of a vacuum. Every one of us is healthier, happier, and some of us are actually still alive, solely because some nameless people made a commitment to research.

Participation in research studies comes in a few broad categories. Some studies seek only patient records in order to establish trends and extract data on the relative successes and failures of various treatment modalities. Other studies administer investigational drugs to patients in double-blind trials as part of the final phases of their approval. At Plasma MedResearch, LLC, we recruit patients for a third type of study. Our participants donate biospecimens in the form of plasma or blood samples along with various other body tissues and fluids as research requirements dictate. These patients are then compensated for their donation, time and travel, depending on the study and the specimen given.

Why are people reluctant to get involved? There are many reasons ranging from logistics, family/work responsibilities, impaired health, lack of mobility, and privacy concerns. These are all very valid reasons to take a pass on participating. In this day and age people are simply not comfortable having their personal information “out there”. This is understandable. Anyone who works with Plasma MedResearch, LLC, can rest assured that their personal information is protected. We meet and exceed all existing HIPAA and regulatory requirements for the safeguarding of personal information. Our commitment to our donors’ privacy cannot overstated.

We serve biotechnology companies, pharmaceutical companies, and Universities around the world. Our capabilities include a wide range of disease-state biospecimens, from Arthritis to Zika. People who consider donating often ask to know what research institution will be using their specimen and the exact nature of the study. Although this is a great question, it is not possible to answer. Regulations require a strict de-linking between donor and researcher. The most important part of this that researchers cannot know any identifying information about the person who provided the specimen. This is a critical protection for the donor. But, as a consequence, the donor cannot be privy to information about the people and company(ies) doing the actual research.

The selfless act of donating a specimen to a particular research study will have a positive ripple effect down through the generations, improving the quality of life on planet Earth.