Urinary Excretion of C5b-9 in Severe Preeclampsia Tipping the Balance of Complement Activation in Pregnancy
Urinary Excretion of C5b-9 in Severe Preeclampsia Tipping the Balance of Complement Activation in Pregnancy
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DOI：
10.1161/hypertensionaha.113.01420
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发表时间：
2013-12-01
期刊：
影响因子：
8.3
通讯作者：
Feinberg, Bruce B.
中科院分区：
文献类型：
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作者：
Burwick, Richard M.;Fichorova, Raina N.;Feinberg, Bruce B.
补体级联反应在正常妊娠中被激活，并且过度的补体激活在重度先兆子痫中传播全身炎症反应。因此，补体失调的生物标志物可用于预测或治疗疾病。由于伴有蛋白尿的肾损害是先兆子痫的典型病理特征，我们假设尿液中的补体标志物比血浆中的补体标志物更能反映疾病中的补体失调。为了研究这一点，我们对孕妇进行了一项病例对照研究，纳入了25例重度子痫前期患者，25例慢性高血压对照患者和25例无高血压的健康对照者，这些对照者与胎龄和产次相匹配。受试者于2012年3月至2013年3月从Brigham and Women's Hospital招募。在入组当天采集尿液和血液样本，通过ELISA测量补体激活（C3 a、C5 a和C5 b-9）。重度先兆子痫与尿C5 b-9显著升高相关（中位数[四分位数间距]，4.3 [1.2-15.1] ng/mL），相对于慢性高血压受试者（0 [0-0]）和健康对照者（0 [0-0]; P
The complement cascade is activated in normal pregnancy, and excessive complement activation propagates the systemic inflammatory response in severe preeclampsia. Consequently, biomarkers of complement dysregulation may be useful for prediction or treatment of disease. Because renal damage with proteinuria is a characteristic pathological feature of preeclampsia, we hypothesized that complement markers in urine, rather than plasma, could better reflect complement dysregulation in disease. To investigate this, we performed a case-control study of pregnant women, enrolling 25 cases with severe preeclampsia, 25 controls with chronic hypertension, and 25 healthy controls without hypertension matched by gestational age and parity. Subjects were recruited from the Brigham and Women's Hospital from March 2012 to March 2013. Urine and blood samples were collected on the day of enrollment, with complement activation (C3a, C5a, and C5b-9) measured by ELISA. Severe preeclampsia was associated with marked elevations in urinary C5b-9 (median [interquartile range], 4.3 [1.2-15.1] ng/mL) relative to subjects with chronic hypertension (0 [0-0]) and healthy controls (0 [0-0]; P