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Vitamin B3 Nicotinamide: A Promising Candidate for Treating Preeclampsia and Improving Fetal Growth
Nobuyuki Takahashi1,2,3, Feng Li3, Tomofumi Fushima1
1Division of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences.
Insights
Vitamin B3 nicotinamide (Nam) shows promise as a safe treatment for preeclampsia (PE), a serious pregnancy condition. This vitamin alleviates PE symptoms, prevents miscarriage, and improves fetal growth in mouse models.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Pharmacology
Background:
- Preeclampsia (PE) affects up to 8% of pregnant women, causing high blood pressure and organ damage.
- Current treatments for PE are limited, with existing antihypertensives posing risks to fetal development.
- Delivery remains the only definitive treatment for PE, highlighting the urgent need for safe pharmacological interventions.
Purpose of the Study:
- To investigate the efficacy of vitamin B3 nicotinamide (Nam) as a potential therapeutic agent for preeclampsia (PE).
- To evaluate Nam's effects on PE-related complications, including miscarriage, pregnancy duration, and fetal growth.
- To establish Nam as a safe and effective treatment option for PE and associated fetal growth restriction (FGR).
Main Methods:
- Utilized three distinct mouse models specifically designed to mimic different aspects of human preeclampsia (PE).
- Administered vitamin B3 nicotinamide (Nam) to assess its therapeutic effects on PE.
- Monitored key indicators such as blood pressure, endotheliosis, proteinuria, miscarriage rates, pregnancy length, and fetal growth.
Main Results:
- Vitamin B3 nicotinamide (Nam) was identified as the first safe drug to alleviate preeclampsia (PE) in mouse models.
- Nam demonstrated significant efficacy in preventing or alleviating miscarriage and prolonging gestation periods.
- Treatment with Nam led to notable improvements in fetal growth, counteracting fetal growth restriction (FGR) associated with PE.
Conclusions:
- Vitamin B3 nicotinamide (Nam) presents a promising, safe therapeutic strategy for managing preeclampsia (PE) and its associated fetal growth restriction (FGR).
- Nam's ability to improve pregnancy outcomes, including reducing miscarriage and enhancing fetal development, warrants further investigation for human application.
- Given its established safety profile in pregnant women, Nam could potentially offer a novel treatment for PE if proven effective in clinical trials.
Abstract:
Up to 8% of pregnant women suffer from preeclampsia (PE), a deadly disease characterized by high blood pressure (BP), blood vessel damage, called endotheliosis (vascular endothelial swelling with narrowing of capillary lumen), and high levels of protein in the urine. PE is often associated with premature delivery, which is a risk factor of cardiovascular and metabolic diseases among the offspring. Accordingly, establishing drug treatments of PE is in immediate needs. Currently, many of anti-hypertensive drugs cause malformation of the fetuses and are contraindicated for pregnant women. Anti-hypertensive drugs that are allowed to be used for treating pregnant women could lower BP of the mothers and reduce the risk of maternal death due to cardiovascular diseases such as cerebral hemorrhage. However, these anti-hypertensives do not improve endotheliosis and proteinuria. In fact, they reduce blood supply to the placentae and fetuses, which could lead to fetal growth restriction (FGR) and fetal and neonatal death. Until now, the only treatment for preeclamptic women has been delivery of the baby and placenta. Using three mechanistically different mouse models of PE, we have found that vitamin B3 nicotinamide (Nam) is the first safe drug that alleviates PE, and that Nam also alleviates or prevents miscarriage, prolongs pregnancy period, and improves the growth of the fetuses in mice with PE. Importantly, Nam has been used for pregnant and nursing women who have difficulty in taking sufficient meal. Nam could help treat or prevent PE and FGR associated with PE, if the treatment works in humans.
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