A recent study reveals that the stomach-turning nausea and vomiting associated with morning sickness are caused by an increase in a hormone produced by fetuses.
Researchers report December 13 in Nature that people who had naturally low amounts of the protein in their blood prior to pregnancy are more prone to hyperemesis gravidarum, a severe form of morning sickness, when confronted with a protein surge. The results may lead to treatments and assist in identifying individuals who are susceptible to the serious illness.
Early in their pregnancy, up to 80% of women experience nausea and approximately 50% vomit; these symptoms are commonly referred to as (misleadingly) morning sickness. Up to 3% of pregnant women will experience hyperemesis gravidarum, which is intense and frequent vomiting that can cause weight loss, dehydration, hospitalization, and possibly the mother’s or fetus’s death
Dr. Jone Trovik, an obstetrician and gynecologist who was not involved in the study, notes that earlier research suggested morning sickness was brought on by estrogen or other hormones that are increased early in pregnancy. According to her, research has linked infections, high thyroid hormone, and other factors to serious illness.
According to Trovik of the University of Bergen in Norway and the Haukeland University hospital in Haukeland, “the most problematic aspect has been that it has been considered a psychological cause, which has been widely refuted.” “People have suggested to women, ‘Perhaps you shouldn’t be pregnant.'” Perhaps you’re upset with your spouse.
According to Trovik, the latest research offers “evidence that this is a real disease.”
Endocrinologist Stephen O’Rahilly of Cambridge University and colleagues have reported that levels of a protein called GDF15 were greater in the blood of pregnant patients who experienced nausea and vomiting than in those who did not have these symptoms. It was previously discovered that the protein, which is produced all throughout the body and aids in cell response to stress, has an effect on the area of the brain responsible for causing nausea and vomiting.
Hyperemesis gravidarum can strike a person up to ten times more frequently than those without a certain genetic mutation in the GDF15 gene, according to research coauthor Marlena Fejzo and colleagues. But those researchers found that those who had the mutation produce less GDF15 than normal.
Fejzo, a geneticist and hyperemesis gravidarum researcher at the USC Keck School of Medicine in Los Angeles, says the finding was puzzling. Why is the variation linked to severe morning sickness if individuals with it produce low amounts of GDF15 while high levels are linked to nausea and vomiting?
It turns out that individuals with the risk mutation produce less of the protein pre-pregnancy but exhibit higher blood levels of GDF15 during pregnancy. The surprising finding of the study was that the placenta and fetus produce the majority of the GDF15 produced during pregnancy. Those who carry the risk variant are not accustomed to GDF15’s nauseating properties. According to Fejzo, “you’re highly sensitive to them, more so than the average person,” when those high amounts are encountered in the early stages of pregnancy.
On the other hand, GDF15 levels are elevated in those who have beta thalassemia, a rare blood condition. Researchers discovered that throughout pregnancy, those people hardly ever felt sick. According to that research, those who are exposed to the protein prior to becoming pregnant may become less sensitive and less ill.
The notion was tried on mice by the team. Rats given a high dose of the protein reduced their food intake, which is what they usually do when they feel queasy. However, the mice were less disturbed if they had received a lower dose of long-acting GDF15 three days before to the spike. The outcome implies that the effects of a larger dose later on may be mitigated by tiny doses of the protein.
The collective results also point to potential therapeutic approaches. Those who are at risk of hyperemesis gravidarum prior to pregnancy may be prescribed the diabetic medication metformin, which increases GDF15 levels, according to O’Rahilly. Or, medications that prevent GDF15’s effects on the brain might be created in the future.
Fejzo does highlight one important caution, though: since most genetic research was conducted on individuals of European ancestry, it is uncertain that GDF15 plays a significant role in other racial or ethnic groupings.
Additionally, gastroenterologist Sumona Saha states that a plethora of safety data from animal studies will be required by researchers prior to administering any treatment (SN: 4/21/22). According to Saha of the University of Wisconsin School of Medicine and Public Health in Madison, nobody is sure if increasing levels of the protein before to pregnancy could have an impact on conception or what impact inhibiting GDF15 may have on fetal development.
To treat patients with severe nausea and vomiting, doctors currently try a range of antinausea medications, neurological treatments, and other therapy, sometimes including intravenous fluids and nutrition. Therapy centered on GDF15 may enhance care, according to Saha.
Compared to many other therapies that are equivalent to using a hammer on an issue, we may have a very targeted approach. At this point, we might be able to utilize an X-Acto knife.
Related Posts
