A diabetes drug could be the first ever defence against miscarriage, a new study has revealed.
Researchers have discovered that the medicine has a side-effect of increasing the number of stem cells in the womb – improving conditions for pregnancy.
It builds on scientific investigations by the same team at the University of Warwick, which showed thousands of miscarriages are caused by a lack of stem cells – especially for women who repeatedly miscarry.
Recurrent miscarriage is defined as the loss of two or more consecutive pregnancies, with the likelihood of it happening again tragically increasing each time.
The Warwick team also showed that stem cells protect specialised cells, called decidual cells which surround the embryo.
Excessive stress on these key cells can cause breakdown of the womb lining, placental bleeding, and miscarriage.
A new class of diabetes drugs called gliptins targets an enzyme, DPP4, which helps connect stem cells to the womb.
The study found that one in particular, Sitagliptin, was effective not only in increasing stem cells in the womb lining but lowered the number of stressed decidual cells too.
A small group of 36 women, who had each had an average of five miscarriages, took the drug for three menstrual cycles and were found to have around two thirds more stem cells in their wombs at the end.
Meanwhile, the numbers of stressed decidual cells was cut in half.
Even more promisingly, participants have gone on to have successful pregnancies.
The research by Warwick Medical School with University Hospitals Coventry and Warwickshire and supported by the NIHR Coventry and Warwickshire Clinical Research Facility was published today in the journal EBioMedicine.
The researchers now hope to take the treatment to clinical trial and, if successful, it would be the first targeted specifically at the lining of the womb to prevent miscarriage.
Professor Jan Brosens, of Warwick Medical School and Consultant in Reproductive Health at University Hospitals Coventry and Warwickshire NHS Trust, said: “There are currently very few effective treatments for miscarriage and this is the first that aims at normalising the womb before pregnancy.
“Although miscarriages can be caused by genetic errors in the embryo, an abnormal womb lining causes the loss of chromosomal normal pregnancies.
“We hope that this new treatment will prevent such losses and reduce both the physical and psychological burden of recurrent miscarriage.”
Professor Siobhan Quenby from Warwick Clinical Trials Unit and an Honorary Consultant at University Hospital Coventry and Warwickshire NHS Trust, said: “We have improved the environment that an embryo develops in and in doing so we hope to improve the chances of a successful pregnancy.
“Although this research was specifically designed to test whether we could increase the presence of stem cells in the womb, follow-up of participants found that there were no further losses of normal pregnancies in those who took sitagliptin.
“These are very early results and the treatment now needs to be further tested in a large-scale clinical trial.”
Jane Brewin, Chief Executive at Tommy’s National Miscarriage Research Centre, which funded the research, said: “For far too long it has often been said by many health professionals that miscarriage is not preventable, and parents have been left with little hope given the paucity of treatment options available.
“This situation prompted Tommy’s to invest in the Tommy’s National Centre for Miscarriage Research and this breakthrough research by the world leading team at Warwick shows great promise for an effective treatment which will reduce miscarriage and possibly later pregnancy loss too.
“A large-scale trial is needed to verify the findings and we hope that this will get underway quickly.”
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