ACTIVATION OF THE COMPLEMENT PATHWAY - COMPARISON OF NORMAL-PREGNANCY, PREECLAMPSIA, AND SYSTEMIC LUPUS-ERYTHEMATOSUS DURING PREGNANCY
ACTIVATION OF THE COMPLEMENT PATHWAY - COMPARISON OF NORMAL-PREGNANCY, PREECLAMPSIA, AND SYSTEMIC LUPUS-ERYTHEMATOSUS DURING PREGNANCY
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DOI：
10.1111/j.1600-0897.1992.tb00787.x
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发表时间：
1992-10-01
影响因子：
3.6
通讯作者：
BUYON, JP
中科院分区：
文献类型：
--
作者：
ABRAMSON, SB;BUYON, JP
为了评估妊娠期系统性红斑狼疮（SLE）的发作并将其与妊娠期疾病区分开来，经常使用血清学参数。然而，关于补体和激活产物的常规测量的优点，存在相互矛盾的报道。在正常妊娠中，血清C3、C4和CH 50水平逐渐升高，而在选定的SLE患者中，这些水平在妊娠过程中下降。关于这种福尔斯下降是否代表补体或活化的总体合成减少存在争议，前一种理论得到了C1 s-C1抑制剂复合物正常水平的报告的支持。在正常妊娠期间，可能会发生补体裂解产物（如血浆C3 a）的增加，并且这些与C3的升高呈正相关。在妊娠合并狼疮，增加C3 a往往伴随着下降总C3和CH 50。在少数非SLE患者中，先兆子痫与多种补体裂解产物升高有关。Ba、C3 a、C4d、SC 5 b-9，表明经典途径和旁路途径均激活。这些患者的CH 50水平往往保持正常。相反，SLE患者补体裂解产物的升高经常伴随疾病发作。高的CH 50/Ba比值可将先兆子痫患者与活动性SLE患者区分开来。C3、C4或CH 50的常规测量值下降，伴随补体裂解产物升高，似乎可将狼疮发作与妊娠期非SLE疾病区分开来。
To evaluate a flare of systemic lupus erythematosus (SLE) during pregnancy and to differentiate it from diseases of pregnancy, serological parameters are often utilized. However, there are conflicting reports regarding the merit of conventional measurements of complement and activation products. While in normal pregnancy the levels of serum C3, C4, and CH50 gradually rise, a decline in these levels occurs during the course of pregnancy in selected SLE patients. There is controversy regarding whether such falls represent decreases in the overall synthesis of complement or activation, the former theory being supported by a report of normal levels of the C1s-C1 inhibitor complex. During normal pregnancies, increases of complement split products, such as plasma C3a, may occur, and these correlate positively with elevations of C3. In pregnancies complicated by lupus, increases of C3a are often accompanied by a decline in total C3 and CH50. In a minority of non-SLE patients, preeclampsia has been associated with elevations of a variety of complement split products. Ba, C3a, C4d, SC5b-9, indicating activation of both the classical and alternative pathways. The CH50 levels tend to remain normal in these patients. In contrast, elevations of complement split products frequently accompany disease flares in patients with SLE. A high ratio of CH50/Ba may differentiate patients with preeclampsia from those with active SLE. A decline in conventional measures of C3, C4, or CH50 which is accompanied by elevations of complement split products appears to differentiate a lupus flare from non-SLE diseases of pregnancy.