A solid link between the changes of enzymes activities in maternal blood and fetal physiology — a fundamental obstetric physiology.

Around 1970s, I treated many cases of severe preeclampsia, using various antihypertensive drugs and monitor P-LAP activities in maternal sera. In every case I had encountered intra-uterine fetal death, regardless of increased or controlled maternal blood pressure, I was a bit confused. And I was deeply nervous about my attempted treatments without using antihypertensive drugs.

I then searched for historical treatment records of preeclampsia. Finally I found an article published by Smith and Smith (1). This original article was basically suggesting alleviation of symptoms in severe preeclampsia by administration of two kind of sex steroid hormones for up to 7 days or slightly shorter.

In 1969, I attempted with my first patient of severe preeclampsia at my father’s private clinic, a treatment essentially based on two sex steroids. Daily administration with the dose essentially similar to the protocol which we have proposed (2) and strictly monitored by the daily measurement of P-LAP activities, under the consent of the patients and her husband.

Her pregnancy carried over approximately three weeks more in improved hypertensive conditions. Then I decided the termination of pregnancy due to a tendency of decreasing P-LAP activities observed along with increasing blood pressure irrespective sex steroid treatment.

“Sex steroid treatment with dose increasing manner by gestational week (sex steroid treatment)” for severe preeclampsia and preterm labor has limitation in its clinical effect. It is preliminary a stage of the clinical application of P-LAP or APA itself, i.e., administration of recombinant form of these peptidases. Nevertheless, it might be a clinically meaningful tool; that monitoring pathological changes through P-LAP and APA activities in patients with preeclampsia and preterm labor.

Daily injections of two steroid hormones may not be practical. Presently in my clinic, I use depot type administered in every 3 or 4 days interval essentially similar doses to the protocol which we have proposed (2) per gestational week   in accordance with the measurements of maternal serum P-LAP activities.

1.     Smith GV, Smith OW , J Clin Endocrinol 1941;1:477-484]

2.     Mizutani S, Mizutani E, Exp Clin Endocrinol Diabetes 2015;123:159-164








How incorrect and troublesome ― Women’s Health Initiative study (sponsored by NIH).

As being an honorary member of The Endocrine Society, I periodically receive “Endocrine News” produced by the Society.

In April 2016 newsletter, I have found an article titled “Correct Change”. The following sentences appeared: Hormone therapy (HRT) remains the most effective treatment for the vasomotor and other symptoms of menopause, expert panel from the Endocrine Society and allied organizations concluded in a new clinical practical guideline.

Allied organizations are follows: Australasian Menopause Society, British Menopause Society, European Menopause and Andropause Society, European Society of Endocrinology and International Menopause Society.

HRT had been a common practice before the initial findings of the Women’s Health Initiative which appeared 13 years ago.

In other words, HRT has been averted by the clinicians worldwide. In spite of such an environment, I continued HRT at my clinic under somehow inconvenient atmosphere. It is because I have my solid belief: HTR is not the cause of breast cancer and not the cause of thrombosis either (see my previous blog on May 5, 2016). (http://p-lap.doorblog.jp/archives/48289432.html)

After my long research experiences on pathophysiology of preeclampsia, now I have the following concept: While estradiol is the active agent for inducing angiotensinogen and fibrinogen from liver, metabolizing and degrading enzymes opposed to the estradiol actions are also activated in human body. If we assume HRT is carcinogenic, every woman should suffer from cancers. Women’s health is maintained by sex hormones.

Therefore, oral contraceptive pills and HRT must be welcomed by all women no matter where in the world she may live.




Dr.水谷の女性と妊婦講座 No.71 アトピー性皮膚炎は理研が突き止めた原因遺伝子の働きを抑制すると治るのでしょうか?









▽ところで、皆さんは、2014年3月に表面化した横浜市の「漢方クリーム事件」を覚えていらっしゃいますか? ノンステロイドの「漢方クリーム」と称する軟膏でアトピー性皮膚炎を治療するとして、実際は最強力とされるステロイド(副腎皮質ホルモン)入りの軟膏を処方されていました。被害者弁護団によると、被害に遭われた患者さんは2000人以上。アトピー性皮膚炎の患者さんが、いかに多いか、そして治療で悩んでいらっしゃるか。「漢方クリーム事件」は、危険なアトピー性皮膚炎の治療法がいかに浸透しているか、深刻さを浮き彫りにしました。






























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