Recombinant alpha-1-microglobulin: a potential treatment for preeclampsia

• Abnormal formation of free fetal hemoglobin (HbF) is implicated in preeclampsia.
• Leakage of free HbF to the maternal circulation causes endothelial and renal damage.
• Formation of free heme and radical oxygen species contribute to pathology.
• Recombinant human alpha-1-microglobulin (rA1M) counteracts these detrimental effects.
• rA1M has potential to be the first specific pharmacological preeclampsia treatment.

Preeclampsia is a serious pregnancy-specific condition, affecting 10 million women annually worldwide. No specific treatment is currently available. Recent studies have demonstrated abnormal production and accumulation of free fetal hemoglobin in the preeclamptic placenta, and identified subsequent leakage into the maternal circulation as an important factor in the development of preeclampsia. A recombinant version of alpha-1-microglobulin, an endogenous well-characterized heme and radical scavenger, has been developed. Intravenous administration of recombinant alpha-1-microglobulin in animal models has been proved to eliminate or significantly reduce the manifestations of preeclampsia. Recombinant alpha-1-microglobulin has the potential to become the first specific therapy for preeclampsia.