Complement system dysregulation in patients with preeclampsia


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Abstract

Objective: To investigate the role of the complement system in the development and progression of preeclampsia. Materials and methods: A study group comprised 25patients with preeclampsia (13 moderate, 12 severe) and a comparison group of 22 relatively healthy women with uncomplicated pregnancies. Serum levels of complement factors (C1q, C3, C5a, Factor B, Factor H, Factor I, Factor D) were determined before treatment and in the neonatal cord blood immediately after delivery using the Multiplex method (Merck complement panels, Germany). Results: Patients with moderate preeclampsia had significantly elevated levels of C1q, C3, FB, FH, and a less marked increase in FI and FD. A paradoxical reduction in all these factors was seen in patients with severe preeclampsia. C5a levels increased with the progression of preeclampsia, culminating in severe preeclampsia. The changes of neonatal cord blood complement factors overlapped with maternal ones but were less pronounced, with a signif icant increase in C5a in the severe preeclampsia subgroup. Conclusion: The high concentrations of C1q, C3, C5a, FB, FD in pregnant women with preeclampsia suggest complement activation through the classical and alternative pathways, accompanied by a compensatory increase in regulatory FH and FI to limit excessive complement activation. In severe preeclampsia, continuing complement activation is associated with consumption hypocomplementemia.

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About the authors

Iraida S. Sidorova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Email: sidorovais@yandex.ru
Dr. Med. Sci., Professor, Academician of the RAS, Merited Scholar of the Russian Federation, Department of Obstetrics and Gynecology № 1, N.V. Sklifosovsky Institute of Clinical Medicine

Natalya A. Nikitina

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Email: natnikitina@list.ru
Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology № 1, N.V. Sklifosovsky Institute of Clinical Medicine

Mikhail B. Ageev

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Email: mikhaageev@yandex.ru
Ph.D., Teaching Assistant at the Department of Obstetrics and Gynecology №1, N.V. Sklifosovsky Institute of Clinical Medicine

Albert A. Kokin

Maternity Hospital affiliated to the V.V. Veresaev Clinical Hospital of Moscow City Health Department

Email: alberkokin@yandex.ru
Head of the Department of Anesthesiology and Intensive Care

Marina A. Kir'yanova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Postgraduate Student at the Department of Obstetrics and Gynecology №1

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