Diabetes drug may help prevent miscarriages by 'improving' womb of pregnant women and increasing stem cells: Study
If a larger clinical trial shows successful results, the drug can be easily adopted worldwide, says the team
A diabetes drug may help women facing repeated failed pregnancies bear children. A pilot clinical study has shown that the treatment can prevent a miscarriage by making the womb better suited for pregnancy.
The study also showed that women participants who were given the drug sitagliptin experienced no serious side-effects. These women went on to have successful pregnancies. If a larger clinical trial shows successful results, the drug can be easily adopted worldwide, says the team behind the study.
"There are currently very few effective treatments for miscarriage and this is the first that aims at normalizing the womb before pregnancy," says Dr. Jan Brosens, from Warwick Medical School. Dr. Brosens is a consultant in reproductive health at University Hospitals Coventry and Warwickshire NHS Trust, and the lead author of the study.
The experts define recurrent miscarriage as the loss of two or more consecutive pregnancies, with additional miscarriages decreasing the likelihood of a successful pregnancy.
Failed pregnancies occur due to errors in the embryos' genes. But a previous study conducted by Brosens showed that abnormal womb lining can also result in a miscarriage. By targeting the abnormal womb lining, Brosens and his colleagues hoped their new treatment will prevent such losses and reduce the physical and psychological burden of recurrent miscarriages.
The abnormal womb lining is due to a loss of stem cells. Stem cells possess the ability of turning into various types of cells in the body, from muscle to brain, and can repair damaged tissue.
In the case of pregnant women, stem cells in the womb protect the cells surrounding the embryo called decidual cells. But when the womb loses its stem cell reserves, the decidual cells become stressed, disrupting the womb lining during pregnancy. This, in turn, may cause placental bleeding and miscarriage.
So the team were on the lookout for a drug that can boost the womb's stem cell reserves. To test the efficacy of Sitagliptin, the team studied 38 women aged 18 to 42 who had experienced an average of five failed pregnancies. While some received the drug, others were given a placebo for three menstrual cycles. The team also took samples of the womb before and after the study. This was done to have a count on the number of stem cells.
The team found an average increase in stem cell count of 68% in those women who took the full course of sitagliptin. "Women who received the medication for three menstrual cycles had a significant increase in the number of stem cells, whereas no effect was observed in participants taking an identical placebo pill. Furthermore, we also observed a dramatic decrease in the abundance of stressed inflammatory decidual cells," explains Dr. Brosens.
Those taking the drug showed a 50% decrease in the number of 'stressed' cells in the lining of the womb. Further, participants who were treated with sitagliptin did very well in their subsequent pregnancy.
However, only a larger clinical trial will help the team draw meaningful conclusions. "The current study was designed to assess the effect of the drug on stem cells. Thus, a larger clinical trial is needed before this treatment can be introduced into clinical practice," says Dr. Brosens
The study has been published in EBioMedicine.