A novel treatment potential for cardiovascular disease in pregnancy and beyond

Dr Kristen Bubb, Monash University

2020 Vanguard Grant

Years funded: 2021-2023

Preeclampsia is a major complication in pregnancy, involving uncontrolled high blood pressure for the mother. It is relatively common, affecting approximately 3% of pregnancies and can be life-threatening for both mother and baby. Common medicines to lower blood pressure are generally ineffective in preeclampsia. Ultimately, delivery of the placenta is the only cure, meaning that premature delivery of the baby is often required. Due to this, babies born to women with preeclampsia are more likely to experience long-term medical conditions. Women who develop preeclampsia have a high future risk of non-pregnancy-related premature cardiovascular disease. The reasons for this are still being investigated, and there is a clear unmet need for therapeutic intervention to reduce the complications for both mother and baby.

The major underlying cause of preeclampsia is the maladaptation of the blood vessels in the placenta which provide the baby with nutrients and oxygen. The result is inadequate development of the placenta, which puts the baby at risk of poor growth and development. In this study, we propose a new mechanism underpinning the pathogenesis of preeclampsia. We recently discovered a new role for the hormone, C-type natriuretic peptide (CNP). We now know that CNP plays a critical role in blood vessel development and a well-established role in blood pressure regulation. Coupled with the knowledge that circulating CNP levels may predict preeclampsia in some women, we hypothesise that CNP could be a cause of preeclampsia and may offer a new target for its treatment. Here we will characterise the role of CNP in preeclampsia and investigate whether CNP abnormalities in pregnancy are a cause of future cardiovascular disease risk. We will also address whether CNP is a viable treatment strategy during preeclampsia, in order to reduce symptoms, extend the pregnancy and improve outcomes for both the mother and baby.