# Employing biologics to probe GPCR signaling in maternal and fetal health

> **NIH NIH K99** · HARVARD MEDICAL SCHOOL · 2024 · $124,278

## Abstract

Project Summary and Abstract
G protein-coupled receptors (GPCRs) regulate many physiological processes during pregnancy. Oxytocin
receptor (OXTR) signaling initiates labor and aberrant signaling through the angiotensin II type I receptor (AT1R)
is associated with preeclampsia, a hypertensive disorder of pregnancy and leading cause of pregnancy-related
deaths and premature births. GPCRs are therapeutic targets for complications arising during pregnancy and in
assisted reproduction, but current small-molecule and peptide drugs exhibit off-target binding, require constant
intravenous administration due to short half-lives in vivo, and in some cases are fetotoxic limiting their use.
Differing pharmacokinetic and pharmacodynamic profiles and the enhanced specificity make antibodies
attractive therapeutic molecules for targeting GPCRs during pregnancy, but the mechanisms antibodies use to
modulate GPCR signaling is poorly understood. Previous studies with synthetic antibody fragments and
endogenous pathogenic autoantibodies indicate that antibodies can regulate GPCR signaling in a way that does
not mirror the action of prototypical small-molecule and peptide ligands. This proposal combines receptor
pharmacology, structural biology, and antibody engineering to 1) characterize the mechanisms antibody
fragments use to suppress AT1R signaling and demonstrate their ability to selectively target maternal AT1R to
safely treat hypertension during pregnancy, 2) develop antibody selection strategies to mechanistically probe
how synthetic antibody fragments stabilize distinct states of AT1R and OXTR to regulate the recruitment of
signaling effectors and direct biological responses, 3) investigate the mechanisms by which pathogenic
autoantibodies dysregulate AT1R signaling in preeclampsia. Collectively, the proposed research will determine
how antibodies can be leveraged as tools to dissect the finer details of GPCR signaling, provide insight into the
complex pathophysiology of preeclampsia, and identify new avenues to therapeutically target GPCRs to treat
preeclampsia, regulate labor, and improve outcomes in assisted reproduction. The aims described in this
proposal will offer the PI ample opportunities to expand her scientific skillset in structural pharmacology and
antibody engineering, gain training in reproductive biology, and strengthen her expertise in GPCR biology.
Mentorship from Dr. Andrew Kruse, advisory committee members, and collaborators will provide the PI with the
skills needed to complete the proposed work and transition to independence. The extensive training plan for both
scientific and professional development, combined with strong institutional support, will aid the PI in establishing
an interdisciplinary research program studying the molecular function of pregnancy-related GPCRs.

## Key facts

- **NIH application ID:** 10889247
- **Project number:** 5K99HD110612-02
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Meredith Anne Skiba
- **Activity code:** K99 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $124,278
- **Award type:** 5
- **Project period:** 2023-08-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10889247

## Citation

> US National Institutes of Health, RePORTER application 10889247, Employing biologics to probe GPCR signaling in maternal and fetal health (5K99HD110612-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10889247. Licensed CC0.

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