Assistant Professor
University of Mississippi Medical Center
Lorena M. Amaral, PhD, Assistant Professor, University of Mississppi Medical Center, Jackson-MS.
As a new Assistant Professor at University of Mississippi Medical Center (UMMC), I am currently launching my
independent clinical and basic research program in the pathogenesis and treatment of the pregnancy-specific
hypertensive disorder, preeclampsia (PE). There is no known cure and the only effective treatment is delivery of
the fetus and placenta. PE affects 5-7% of all pregnancies in the U.S., and is associated with reduced placental
perfusion and fetal weight, increased inflammation, antiangiogenic factor sFlt-1, vascular endothelial dysfunction
and hypertension. Despite being a leading cause of maternal death and perinatal morbidity, the mechanisms
responsible for the pathogenesis of PE still are unclear. In my recent studies, my lab has shown that PE is a
progesterone deficient state that is associated with an imbalance between TH1/TH2 cells, natural killer (NK)
cells, and inflammatory cytokines which in turn lead to endothelial dysfunction, uterine growth restriction and
high blood pressure. In contrast, healthy normal pregnancy (NP) is associated with elevations in progesterone
and TH2/uterine NK cells favoring immunotolerance of the fetus. Activated lymphocytes during normal pregnancy
express progesterone receptors, which stimulate a protein called Progesterone Induced Blocking Factor (PIBF).
PIBF increases during NP and has been shown to bind IL-4 receptor and stimulate IL-4/TH2 cells, both of which
are reduced during PE. The role of PIBF in PE still unknown, however I believe that levels of PIBF are low in PE
patients that exhibit lower circulating progesterone compared to normal pregnant patients. Over the past few
years, I have mentored graduate students/Fellows and served as PI or Co-investigator on a number of clinical projects
that have investigated preeclampsia and gestational hypertension.