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Kurokawa M, Takeshita A, Hashimoto S, Koyama M, Morimoto Y, Tachibana D. Prevention of intrauterine fetal growth restriction by administrating C1q/TNF-related protein 6, a specific inhibitor of the alternative complement pathway. J Assist Reprod Genet 2022; 39:2191-2199. [PMID: 35907048 PMCID: PMC9474761 DOI: 10.1007/s10815-022-02582-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/19/2022] [Indexed: 10/16/2022] Open
Abstract
PURPOSE The latest treatments do not sufficiently prevent miscarriage and fetal growth restriction (FGR) in pregnant women. Here, we assessed the effects of a human protein, CTRP6, that specifically inhibits the activation of the alternative complement pathway on miscarriage, fetal and placental development. METHODS Pregnant CBA/J mice mated with DBA/2 male mice as a model of spontaneous abortion and FGR were randomly divided into the control and CTRP6 groups. In the CTRP6 group, the mice were intravenously administered CTRP6 on days 4.5 and 6.5 post-conception (dpc). The abortion rate and fetal and placental weights on 14.5 dpc were examined. Remodeling of the spiral artery was also assessed. RESULTS The abortion rate in the CTRP6 group (13%) was reduced compared to the control group (21%), but there was no statistical difference. The placental and fetal weights in the CTRP6 group were also heavier than those in the control (P < 0.05). Moreover, the thickness of the blood vessel wall in the CTRP6 group was significantly thinner than that in the control (P < 0.05) and comparable to that in the non-abortion model (CBA/J x BALB). The ratio of the inner-per-the-outer diameter of the spiral artery increased more in the CTRP6 group than that in the control (P < 0.05). As well, the Th1/Th2 cytokine ratio was significantly reduced by CTRP6 treatment. CONCLUSIONS Taken together, the supplementation with a protein that regulates the alternative complement pathway in vivo improves FGR and promotes spiral artery remodeling in a mouse model of miscarriage and FGR.
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Affiliation(s)
- Mayu Kurokawa
- Women's Lifecare Medicine, Obstetrics and Gynecology, School of Medicine, Osaka City University, 545-8585, Osaka, Japan
- Graduate School of Medicine, Reproductive Science, Osaka City University, Osaka, 545-8585, Japan
| | - Ai Takeshita
- Graduate School of Medicine, Reproductive Science, Osaka City University, Osaka, 545-8585, Japan
- Department of Anatomy and Neurobiology, Faculty of Medicine, Kindai University, Osaka, 589-8511, Japan
| | - Shu Hashimoto
- Graduate School of Medicine, Reproductive Science, Osaka City University, Osaka, 545-8585, Japan.
| | - Masayasu Koyama
- Women's Lifecare Medicine, Obstetrics and Gynecology, School of Medicine, Osaka City University, 545-8585, Osaka, Japan
| | | | - Daisuke Tachibana
- Women's Lifecare Medicine, Obstetrics and Gynecology, School of Medicine, Osaka City University, 545-8585, Osaka, Japan
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He YD, Xu BN, Wang ML, Wang YQ, Yu F, Chen Q, Zhao MH. Dysregulation of complement system during pregnancy in patients with preeclampsia: A prospective study. Mol Immunol 2020; 122:69-79. [PMID: 32305690 DOI: 10.1016/j.molimm.2020.03.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/19/2020] [Accepted: 03/30/2020] [Indexed: 02/06/2023]
Abstract
Recent studies have shown that aberrant activation of the complement system plays an important role in the pathogenesis of preeclampsia. There is evidence to suggest that aberrant activation of the complement system may already be present during the first trimester. Here, we performed a prospective study in which peripheral blood samples were collected from 500 women during pregnancy. Twenty-one patients (41 specimens) suffering from preeclampsia later in pregnancy were classified into the study group, and sixty-three gravidas with normal pregnancies (136 specimens) were selected as the control group. The plasma concentrations of complement factor B (CFB), C1q, complement factor H (CFH), C3c, C4, C3a, C5a and soluble C5b-9 (sC5b-9) were measured. The levels of CFB (P = 0.004), CFH (P = 0.002), C1q (P = 0.044), C3c (P = 0.032) and C4 (P = 0.015) were significantly higher in preeclampsia than in normal pregnancy during the first trimester, and these levels became similar to those in normal pregnancy thereafter. Before the onset of preeclampsia, the levels of C3a, C5a and sC5b-9 in the preeclampsia group were similar to those in control group even in late pregnancy. C3a levels showed a significant positive correlation with C5a in normal pregnancy (r=0.658, P<0.01) but not in preeclampsia (r = 0.001, P = 1).Thus, we found that aberrant activation of the complement system in patients with preeclampsia was initiated during the first trimester but returned to normal pregnancy levels in the second trimester. At the same time, there is aberrant regulation of complement activation at the C3a-C5a level in preeclampsia during pregnancy.
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Affiliation(s)
- Ying-Dong He
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, PR China
| | - Bing-Ning Xu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, PR China
| | - Meng-Lu Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, PR China
| | - Ya-Qin Wang
- Key Laboratory of Renal Disease, Ministry of Health of China, Renal Division, Department of Medicine, Peking University First Hospital, PR China
| | - Feng Yu
- Key Laboratory of Renal Disease, Ministry of Health of China, Renal Division, Department of Medicine, Peking University First Hospital, PR China
| | - Qian Chen
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, PR China.
| | - Ming-Hui Zhao
- Key Laboratory of Renal Disease, Ministry of Health of China, Renal Division, Department of Medicine, Peking University First Hospital, PR China; Peking-Tsinghua Center for Life Sciences, Beijing, PR China
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3
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He YD, Xu BN, Song D, Wang YQ, Yu F, Chen Q, Zhao MH. Normal range of complement components during pregnancy: A prospective study. Am J Reprod Immunol 2019; 83:e13202. [PMID: 31646704 PMCID: PMC7027513 DOI: 10.1111/aji.13202] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 10/03/2019] [Accepted: 10/18/2019] [Indexed: 12/14/2022] Open
Abstract
Problem The complement system plays a key role in normal placentation, and delicate regulation of complement system activation is critical for successful pregnancy. Therefore, establishing a normal range of complement components during pregnancy is important for clinical evaluation and research. Methods We performed a prospective study to investigate the normal range of complement components in circulation during different stages of pregnancy. Plasma concentrations of complement factor B (CFB), C1q, complement factor H (CFH), C3, C3c, and C4 were measured using an immunoturbidimetric assay; mannan‐binding lectin (MBL), C3a, C5a, and soluble C5b‐9 (sC5b‐9) levels at different time points of pregnancy were determined by enzyme‐linked immunosorbent assay (ELISA). Results A total of 733 plasma samples were collected from 362 women with a normal pregnancy and 65 samples from non‐pregnant women. In the first trimester of pregnancy, the levels of CFB, CFH, MBL, C3c, C4, and C3a were 414.5 ± 85.9 mg/L (95% CI for mean: 402.4‐426.6 mg/L), 381.0 ± 89.0 mg/L (95% CI for mean: 368.5‐393.6 mg/L), 4274.5 ± 2752 ng/mL (95% CI for mean: 3881.1‐4656.4 ng/mL), 1346.9 ± 419.8 mg/L (95% CI for mean: 1287.7‐1406.0 mg/L), 357.4 ± 101.8 mg/L (95% CI for mean: 343.0‐371.7 mg/L), and 182.5 ± 150.0 ng/mL (95% CI for mean: 186.9‐229.1 ng/mL), respectively. The levels of C3 and C4 increased gradually throughout pregnancy. The levels of C1q, C5a, and sC5b‐9 in the first and second trimesters were nearly the same as those in non‐pregnant women. Conclusion The results of this study show that pregnancy itself may influence the plasma levels of complement system components.
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Affiliation(s)
- Ying-Dong He
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Bing-Ning Xu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Di Song
- Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China.,Department of Medicine, Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Ya-Qin Wang
- Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China.,Department of Medicine, Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Feng Yu
- Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China.,Department of Medicine, Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Qian Chen
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Ming-Hui Zhao
- Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China.,Department of Medicine, Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
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Sheng YR, Hu WT, Wei CY, Tang LL, Liu YK, Liu YY, Qiu JP, Li DJ, Zhu XY. Insights of efferocytosis in normal and pathological pregnancy. Am J Reprod Immunol 2019; 82:e13088. [PMID: 30614132 DOI: 10.1111/aji.13088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/21/2018] [Accepted: 12/31/2018] [Indexed: 12/18/2022] Open
Abstract
Efferocytosis, which is known as the phagocytic clearance of dying cells by professional as well as non-professional phagocytes, including a great number of intracellular/extracellular factors and signals, is interrelated with the immune system, contributing to local and systemic homeostasis, especially in tissues with high constitutive rates of apoptosis. Accumulating studies have indicated that immune dysregulation is associated with the pathogenesis of the female reproductive system, which causes preeclampsia (PE), recurrent spontaneous abortion (RSA), ruptured ectopic pregnancy, and so on. And some studies have revealed the pleiotropic and essential role of efferocytosis in these obstetrical disorders. More specifically, the occurrence and development of these diseases were in connection with some efferocytosis-related factors and signals, such as C1q, MBL, and IL-33/ST2. In this review, we systematically review the diverse impacts of efferocytosis in immune system and discuss its relevance to normal and pathological pregnancy. These findings may instruct future basic researches as well as clinical applications of efferocytosis-related factors and signals as latent predictors or therapeutic targets on the obstetrical disorders.
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Affiliation(s)
- Yan-Ran Sheng
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, China
| | - Wen-Ting Hu
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, China
| | - Chun-Yan Wei
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, China
| | - Ling-Li Tang
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, China
| | - Yu-Kai Liu
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, China
| | - Yu-Yin Liu
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, China
| | - Jian-Ping Qiu
- Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Da-Jin Li
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, China.,Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Xiao-Yong Zhu
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, China.,Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
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5
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Larsen JB, Andersen AS, Hvas CL, Thiel S, Lassen MR, Hvas AM, Hansen AT. Lectin pathway proteins of the complement system in normotensive pregnancy and pre-eclampsia. Am J Reprod Immunol 2019; 81:e13092. [PMID: 30672631 DOI: 10.1111/aji.13092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/21/2018] [Accepted: 01/11/2019] [Indexed: 12/27/2022] Open
Abstract
PROBLEM The lectin pathway of the complement system may be involved in the pathogenesis of pre-eclampsia. We aimed to investigate changes in serum concentrations of a broad range of lectin pathway proteins during normal pregnancy and their association with pre-eclampsia, placental infarctions and intrauterine growth restriction (IUGR). METHOD OF STUDY We included 51 women with normotensive pregnancies and 54 women with pregnancies complicated by pre-eclampsia. Blood samples were obtained at gestational weeks 16, 33, 37, and after delivery for the normotensive pregnant women and before and after delivery for women with pre-eclampsia. Mannose-binding lectin (MBL), H- and M-ficolin, collectin liver-1 (CL-L1), MBL-associated serine protease (MASP)-1, MASP-2 and MASP-3 and MBL-associated proteins of 19 (MAp19) and 44 (MAp44) kDa were analysed. Clinical information was obtained from medical records. The placentae were examined by two experienced perinatal pathologists. RESULTS Lectin pathway protein concentrations generally increased during normal pregnancy and decreased after delivery in both normotensive pregnant women and women with pre-eclampsia. Exceptions were MASP-3 which increased after delivery in both groups (P < 0.0001) and H-ficolin which increased after delivery in pre-eclampsia (P < 0.0001). H-ficolin (P < 0.0001), M-ficolin (P = 0.005) and MASP-3 (P = 0.03) concentrations were lower in women with pre-eclampsia than in normotensive pregnant women. Low MASP-3 concentrations were associated with placental infarction (P = 0.03) and IUGR (P = 0.04). Low H-ficolin concentrations were associated with IUGR (P < 0.01). CONCLUSION In general, lectin pathway protein serum concentrations increased during normal pregnancy. H-ficolin and MASP-3 may be involved in the pathophysiology of pre-eclampsia and IUGR and could be potential future pre-eclampsia biomarkers.
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Affiliation(s)
| | | | | | - Steffen Thiel
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | - Anne-Mette Hvas
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anette Tarp Hansen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
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6
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Wu W, Yang H, Feng Y, Zhang P, Li S, Wang X, Peng T, Wang F, Xie B, Guo P, Li M, Wang Y, Zhao N, Wang D, Wang S, Zhang Y. Polymorphisms in complement genes and risk of preeclampsia in Taiyuan, China. Inflamm Res 2016; 65:837-45. [PMID: 27405496 DOI: 10.1007/s00011-016-0968-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/20/2016] [Accepted: 06/21/2016] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Altered immune response may be a part of the pathogenesis of preeclampsia. The few epidemiologic studies that have investigated the associations between genetic variations in the complement system genes and preeclampsia risk have reached inconsistent results. The aim of this study is to determine if polymorphisms in the complement system genes could influence the risk of preeclampsia. METHODS We examined 51 SNPs in the C3, C5, C6, MASP1, MBL2 and CD55 genes and the risk of preeclampsia and its clinical subtypes in a nested case-control study of 203 preeclampsia cases and 233 controls. RESULTS Both C6 and MASP1 were associated with the risk of preeclampsia. C6 (rs7444800, rs4957381) and MASP1 (rs1108450, rs3774282, rs698106) polymorphisms were associated with the risk of early-onset preeclampsia and severe preeclampsia, while MASP1 (rs1357134, rs698090) polymorphisms were associated with the risk of late-onset preeclampsia and severe preeclampsia. CONCLUSIONS Our study provided novel evidence that genetic variations in complement genes C6 and MASP1were associated with preeclampsia risk, and that the risk varied by preeclampsia subtypes.
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Affiliation(s)
- Weiwei Wu
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China
| | - Hailan Yang
- Department of Obstetrics, the First Affiliated Hospital, Shanxi Medical University, Taiyuan, China
| | - Yongliang Feng
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China
| | - Ping Zhang
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China
| | - Shuzhen Li
- Department of Information, the First Affiliated Hospital, Shanxi Medical University, Taiyuan, China
| | - Xin Wang
- Center for Disease Control and Prevention, Taiyuan Railway Administration, Taiyuan, China
| | - Tingting Peng
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China
| | - Fang Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China
| | - Bingjie Xie
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China
| | - Pengge Guo
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China
| | - Mei Li
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China
| | - Ying Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China
| | - Nan Zhao
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
| | - Dennis Wang
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA
| | - Suping Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China.
| | - Yawei Zhang
- Department of Epidemiology, Shanxi Medical University School of Public Health, 56 Xinjian South Road, Taiyuan, 030001, Shanxi, China.
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA.
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7
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Madhukaran SP, Alhamlan FS, Kale K, Vatish M, Madan T, Kishore U. Role of collectins and complement protein C1q in pregnancy and parturition. Immunobiology 2016; 221:1273-88. [PMID: 27349595 DOI: 10.1016/j.imbio.2016.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/27/2016] [Accepted: 06/09/2016] [Indexed: 12/18/2022]
Abstract
Collectins such as surfactant proteins SP-A, SP-D, and mannan-binding lectin (MBL), as well as complement protein C1q are evolutionarily conserved innate immune molecules. They are known to opsonize a range of microbial pathogens (bacteria, fungi, virus, and parasites) and trigger effector clearance mechanisms involving phagocytosis and/or complement activation. Collectins and C1q have also attracted attention in studies involving pregnancy as they are expressed in the female reproductive tissues during pregnancy; a unique state of immune suppression with increased susceptibility to infectious diseases. Recent studies are beginning to unravel their functional significance in implantation, placentation, pregnancy maintenance and parturition in normal and adverse pregnancies. Collectins and C1q, expressed in gestational tissues during pregnancy, might alter the status of mother's immune response to the allogenic fetus and the microenvironment, thereby serving as important regulators of fetus-mother interaction. Here, we discuss the functional roles that have been assigned to SP-A, SP-D, MBL and C1q in pregnancy and parturition.
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Affiliation(s)
- Shanmuga Priyaa Madhukaran
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, United Kingdom; Centre for Biotechnology and Bioinformatics, School of Life Sciences, Jawaharlal Nehru Institute for Advanced Studies, Secunderabad, Telangana, India
| | - Fatimah S Alhamlan
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Kavita Kale
- Department of Innate Immunity, National Institute for Research in Reproductive Health (ICMR), Mumbai 400 012, India
| | - Manu Vatish
- Nuffield Department of Obstetrics & Gynaecology, University of Oxford, Oxford, OX3 9DU, United Kingdom
| | - Taruna Madan
- Department of Innate Immunity, National Institute for Research in Reproductive Health (ICMR), Mumbai 400 012, India
| | - Uday Kishore
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, United Kingdom.
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8
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Potlukova E, Freiberger T, Limanova Z, Jiskra J, Telicka Z, Bartakova J, Springer D, Vitkova H, Trendelenburg M. Association between low levels of Mannan-binding lectin and markers of autoimmune thyroid disease in pregnancy. PLoS One 2013; 8:e81755. [PMID: 24339961 PMCID: PMC3858249 DOI: 10.1371/journal.pone.0081755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 10/16/2013] [Indexed: 01/22/2023] Open
Abstract
Functional deficiency of mannan-binding lectin (MBL) has been associated with adverse pregnancy outcome. Adverse events during pregnancy have also been described in women with autoimmune thyroid diseases (AITD), and thyroid hormones have been shown to influence serum levels of MBL. Therefore, the aim of this study was to analyse the impact of MBL-deficiency on the outcome of pregnancy in relation to the presence of AITD. Almost one year after delivery, we assessed serum MBL levels and MBL2-genotypes in 212 women positively screened for AITD in pregnancy. In 103 of these women, we could also measure MBL levels in frozen serum samples from the 9-12th gestational week, obtaining 96 pairs of MBL values (pregnancy vs. follow-up). As controls, 80 sera of pregnant women screened negatively for AITD were used. MBL2-genotyping was performed using multiplex PCR. Women with thyroid dysfunction and/or thyroid peroxidase antibodies (TPOAb) had lower MBL levels during pregnancy than controls, (3275 vs. 5000 ng/ml, p<0.05). The lowest levels were found in women with elevated thyroid-stimulating hormone (TSH) levels in the absence of TPOAb (2207 ng/ml; p<0.01 as compared to controls). MBL2 genotype distribution did not differ between subgroups. At a median follow-up period of 17 months (range: 3–78 months) after delivery, median MBL level had decreased further to 1923 ng/ml (p<0.0001) without significant changes in TSH. In an explorative survey, functional MBL-deficiency was neither linked to a history of spontaneous abortion, nor other obstetric complications, severe infections throughout life/pregnancy or antibiotics use in pregnancy. In conclusion, hypothyroidism during pregnancy is associated with decreased MBL levels, and the levels decreased further after delivery.
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Affiliation(s)
- Eliska Potlukova
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Tomas Freiberger
- Centre for Cardiovascular Surgery and Transplantation, Molecular Genetics Laboratory, Brno, Czech Republic, and Ceitec and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zdenka Limanova
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jan Jiskra
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Zdenek Telicka
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jana Bartakova
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Drahomira Springer
- Institute of Clinical Biochemistry and Laboratory Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Hana Vitkova
- Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Marten Trendelenburg
- Laboratory of Clinical Immunology, Department of Biomedicine, University Hospital Basel, Switzerland
- * E-mail:
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9
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Halmos A, Rigó J, Szijártó J, Füst G, Prohászka Z, Molvarec A. Circulating ficolin-2 and ficolin-3 in normal pregnancy and pre-eclampsia. Clin Exp Immunol 2012; 169:49-56. [PMID: 22670778 PMCID: PMC3390473 DOI: 10.1111/j.1365-2249.2012.04590.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2012] [Indexed: 01/23/2023] Open
Abstract
Ficolins are soluble molecules of the innate immune system that recognize carbohydrate molecules on microbial pathogens, apoptotic and necrotic cells. They act through two distinct routes: initiating the lectin pathway of complement activation and mediating a primitive opsonophagocytosis. In this study, we measured plasma levels of ficolin-2 and ficolin-3 in 60 pre-eclamptic patients, 60 healthy pregnant women and 59 healthy non-pregnant women by enzyme-linked immunosorbent assay (ELISA). Circulating levels of complement activation products (C4d, C3a, SC5b9), angiogenic factors (soluble fms-like tyrosine kinase-1, placental growth factor) and markers of endothelial activation (von Willebrand factor antigen), endothelial injury (fibronectin) and trophoblast debris (cell-free fetal DNA) were also determined. Plasma levels of ficolin-2 were significantly lower in healthy pregnant than in healthy non-pregnant women, while ficolin-3 levels did not differ significantly between the two groups. Furthermore, pre-eclamptic patients had significantly lower ficolin-2 and ficolin-3 concentrations than healthy non-pregnant and pregnant women. In the pre-eclamptic group, plasma ficolin-2 levels showed a significant positive correlation with serum placental growth factor (PlGF) concentrations and significant inverse correlations with serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1), blood urea nitrogen and creatinine, serum lactate dehydrogenase activities, as well as with plasma VWF:antigen, fibronectin and cell-free fetal DNA concentrations. In conclusion, circulating levels of ficolin-2 are decreased in the third trimester of normal pregnancy. There is a further decrease in plasma ficolin-2 concentrations in pre-eclampsia, which might contribute to the development of the maternal syndrome of the disease through impaired removal of the trophoblast-derived material released into the maternal circulation by the hypoxic and oxidatively stressed pre-eclamptic placenta.
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Affiliation(s)
- A Halmos
- First Department of Obstetrics and Gynecology, Semmelweis University, Hungarian Academy of Sciences, Budapest, Hungary
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Boldt ABW, Goeldner I, de Messias-Reason IJT. Relevance of the lectin pathway of complement in rheumatic diseases. Adv Clin Chem 2012; 56:105-53. [PMID: 22397030 DOI: 10.1016/b978-0-12-394317-0.00012-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Due to its importance both in the clearance of pathogens that contribute as rheumatic etiological agents and in the disposal of apoptotic bodies and potential autoimmune initiators, deficiencies of the components of the lectin pathway of complement have been found to increase susceptibility and modulate the severity of most rheumatic disorders. This chapter introduces the general aspects of the structure, function, and genetics of lectin pathway components and summarizes current knowledge of the field regarding rheumatic diseases predisposition and modulation.
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Affiliation(s)
- Angelica B W Boldt
- Molecular Immunopathology Laboratory, Department of Medical Pathology, Federal University of Paraná, Curitiba, Brazil
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Laisk T, Peters M, Salumets A. Mannose-binding lectin genotypes: potential role in tubal damage and adverse IVF outcome. J Reprod Immunol 2011; 92:62-7. [DOI: 10.1016/j.jri.2011.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Revised: 09/19/2011] [Accepted: 09/22/2011] [Indexed: 01/26/2023]
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Best LG, Nadeau M, Davis K, Lamb F, Bercier S, Anderson CM. Genetic variants, immune function, and risk of pre-eclampsia among American Indians. Am J Reprod Immunol 2011; 67:152-9. [PMID: 22004660 DOI: 10.1111/j.1600-0897.2011.01076.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PROBLEM To determine the prevalence in an American Indian population of genetic variants with putative effects on immune function and determine if they are associated with pre-eclampsia (PE). METHOD OF STUDY In a study of 66 cases and 130 matched controls, six single nucleotide polymorphisms (SNP) with either previously demonstrated or postulated modulating effects on the immune system were genotyped. Allele frequencies and various genetic models were evaluated by conditional logistic regression in both univariate and multiply adjusted models. RESULTS Although most genetic variants lacked evidence of association with PE, the minor allele of the CRP related, rs1205 SNP in a dominant model with adjustment for age at delivery, nulliparity, and body mass index, exhibited an odds ratio of 0.259 (95% CI of 0.08-0.81, P=0.020) in relation to severe PE (48 cases). The allelic prevalence of this variant was 46.1% in this population. CONCLUSION Of the six SNPs related to immune function in this study, a functional variant in the 3'UTR of the CRP gene was shown to be associated with severe PE in an American Indian population.
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Affiliation(s)
- Lyle G Best
- Department of Natural Sciences, Turtle Mountain Community College, Belcourt, ND 58366, USA.
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Girardi G, Prohászka Z, Bulla R, Tedesco F, Scherjon S. Complement activation in animal and human pregnancies as a model for immunological recognition. Mol Immunol 2011; 48:1621-30. [DOI: 10.1016/j.molimm.2011.04.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 04/08/2011] [Accepted: 04/11/2011] [Indexed: 12/16/2022]
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Vianna P, Da Silva GK, Dos Santos BP, Bauer ME, Dalmáz CA, Bandinelli E, Chies JAB. Association between mannose-binding lectin gene polymorphisms and pre-eclampsia in Brazilian women. Am J Reprod Immunol 2011; 64:359-74. [PMID: 20408832 DOI: 10.1111/j.1600-0897.2010.00846.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
PROBLEM Mannose-binding lectin (MBL) is involved in the maintenance of an inflammatory environment in uterus. High MBL levels have been associated with successful pregnancies whereas low levels are involved in pre-eclampsia (PE) development. Here, we evaluated MBL2 gene polymorphisms in the structural and promoter regions addressing their association with PE. METHOD OF STUDY DNA samples from 162 control pregnant women and 157 pregnant PE women were genotyped and data compared with demographic and clinical characteristics. RESULTS High frequency of C and D alleles (related to low MBL levels) was observed in PE women when compared to controls (C: 0.08 versus 0.03, P = 0.006; D: 0.10 versus 0.05, P = 0.009). Grouping the MBL genotypes according to phenotype, a higher frequency of OO genotype was observed in PE women when compared to control women (0.15 versus 0.04, P = 0.007). CONCLUSION Our data suggest that women with genotypes associated with low MBL levels could be potential PE developers.
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Affiliation(s)
- Priscila Vianna
- Department of Genetics, Federal University of Rio Grande do Sul, Porto Alegre, RS - Brazil
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van de Geijn FE, de Man YA, Wuhrer M, Willemsen SP, Deelder AM, Hazes JMW, Dolhain RJEM. Mannose-binding lectin does not explain the course and outcome of pregnancy in rheumatoid arthritis. Arthritis Res Ther 2011; 13:R10. [PMID: 21281477 PMCID: PMC3241354 DOI: 10.1186/ar3231] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 12/23/2010] [Accepted: 01/31/2011] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Rheumatoid arthritis (RA) improves during pregnancy and flares after delivery. It has been hypothesized that high levels of the complement factor mannose-binding lectin (MBL) are associated with a favourable disease course of RA by facilitating the clearance of pathogenic immunoglobulin G (IgG) lacking galactose sugar moieties. During pregnancy, increased galactosylation of IgG and simultaneously increased MBL levels can be observed, with the latter being strictly related to maternal MBL genotypes. Therefore, increased MBL levels in concert with increased IgG galactosylation may be associated with pregnancy-induced improvement of RA. The objective of this study was to investigate whether MBL genotypes are associated with changes in RA disease activity and with changes in IgG galactosylation during pregnancy and in the postpartum period. We also studied the association between MBL genotypes and pregnancy outcomes in RA. METHODS Serum from 216 patients with RA and 31 healthy controls participating in the Pregnancy-induced Amelioration of Rheumatoid Arthritis (PARA) Study was collected before, during and after pregnancy. IgG galactosylation was determined by performing matrix-assisted laser desorption/ionization time of flight mass spectrometry. Disease activity was determined using the internationally recognized Disease Activity Score 28 (DAS28). MBL genotypes were determined. The pregnancy outcome measures studied were gestational age, birth weight, miscarriage and hypertensive disorders. RESULTS No association was found between the MBL genotype groups and changes in RA disease activity (P = 0.89) or changes in IgG galactosylation (patients, P = 0.75, and controls, P = 0.54) during pregnancy and in the postpartum period. Furthermore, MBL genotype groups were not related to the studied pregnancy outcome measures. CONCLUSIONS This study does not provide evidence for a role for MBL in the improvement of RA during pregnancy or for a role for MBL in pregnancy outcome.
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Affiliation(s)
- Fleur E van de Geijn
- Department of Rheumatology, Erasmus University Medical Center Rotterdam, Dr. Molewaterplein 50, NL-3015 GE, Rotterdam, The Netherlands.
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Csuka D, Molvarec A, Derzsy Z, Varga L, Füst G, Rigó J, Prohászka Z. Functional analysis of the mannose-binding lectin complement pathway in normal pregnancy and preeclampsia. J Reprod Immunol 2010; 87:90-6. [DOI: 10.1016/j.jri.2010.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 07/05/2010] [Accepted: 07/22/2010] [Indexed: 01/07/2023]
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Vaisbuch E, Romero R, Erez O, Mazaki-Tovi S, Kusanovic JP, Soto E, Dong Z, Chaiworapongsa T, Kim SK, Ogge G, Pacora P, Yeo L, Hassan SS. Activation of the alternative pathway of complement is a feature of pre-term parturition but not of spontaneous labor at term. Am J Reprod Immunol 2010; 63:318-30. [PMID: 20163401 DOI: 10.1111/j.1600-0897.2009.00800.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PROBLEM Plasma concentrations of fragment Bb (FBb) are a marker for activation of the alternative pathway of the complement system. High concentrations of FBb in maternal blood, as early as the first trimester, are associated with subsequent spontaneous pre-term delivery <34 weeks of gestation. The aim of this study was to determine whether spontaneous pre-term labor (PTL) with intact membranes, intra-amniotic infection/inflammation (IAI) or labor at term are associated with alterations in circulating maternal FBb concentrations. METHOD OF STUDY This cross-sectional study included women in the following groups: (i) non-pregnant (n = 40); (ii) normal pregnancy (gestational age range 20-36, 6/7 weeks, n = 63); (iii) women at term not in labor (n = 70); (iv) women at term in spontaneous labor (n = 59); (v) patients with an episode of PTL who delivered at term (n = 62); (vi) PTL without IAI who delivered pre-term (n = 30); and (vii) PTL with IAI who delivered pre-term (n = 67). Maternal plasma FBb concentrations were determined by ELISA. RESULTS (i) Among patients with PTL, those who had a pre-term delivery either with IAI (1.21 microg/mL, IQR 0.77-2.16) or without IAI (1.13 microg/mL, IQR 0.92-2.08) had a higher median maternal plasma FBb concentration than those who delivered at term (0.86 microg/mL, IQR 0.64-1.57; P = 0.007 and P = 0.026, respectively); (ii) there was no difference in the median plasma FBb concentration between patients with and without IAI who delivered pre-term (P = 0.9); (iii) in contrast, spontaneous labor at term was not associated with a significant change in the maternal plasma FBb concentration (P = 0.8); (iv) maternal plasma concentration of FBb did not differ significantly between normal pregnant women and the non-pregnant controls (P = 0.8) and were not correlated with advancing gestational age (r = -0.28, P = 0.8). CONCLUSION (i) Pre-term parturition is associated with activation of the alternative complement pathway in maternal circulation; (ii) such activation is not detectable in spontaneous labor at term; (iii) IAI does not explain the activation of the alternative pathway of complement in PTL. Collectively, these observations suggest that pre-term and term labors have fundamental differences in the regulation of innate immunity.
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Affiliation(s)
- Edi Vaisbuch
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA
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Than NG, Romero R, Erez O, Kusanovic JP, Tarca AL, Edwin SS, Kim JS, Hassan SS, Espinoza J, Mittal P, Mazaki-Tovi S, Friel L, Gotsch F, Vaisbuch E, Camacho N, Papp Z. A role for mannose-binding lectin, a component of the innate immune system in pre-eclampsia. Am J Reprod Immunol 2009; 60:333-45. [PMID: 18727690 DOI: 10.1111/j.1600-0897.2008.00631.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PROBLEM Mannose-binding lectin (MBL) is a pattern-recognition receptor that activates complement and modulates inflammation. Homozygosity for the most common allele of the MBL2 gene that is associated with high MBL serum concentrations is more prevalent among patients with pre-eclampsia. The objective of this study was to determine maternal plasma MBL concentrations in normal pregnant women and patients with pre-eclampsia. METHOD OF STUDY This cross-sectional study included normal pregnant women (n = 187) and patients with pre-eclampsia (n = 99). Maternal plasma MBL concentrations were determined by ELISA. RESULTS Women with pre-eclampsia had a higher median maternal plasma MBL concentration than normal pregnant women. MBL concentration distribution curves were three-modal, the subintervals in normal pregnancy were low (< 143.7), intermediate (143.7-1898.9) and high (> 1898.9 ng/mL). The proportion of normal pregnant women was larger in the low subinterval, while the proportion of patients with preeclampsia was larger in the high subinterval (P = 0.02). Normal pregnant women in the high subinterval had a larger rate of placental underperfusion than those in the low and intermediate subintervals (P = 0.02). CONCLUSIONS The median maternal plasma MBL concentration is elevated in patients with pre-eclampsia and a larger proportion of these patients are in the high subinterval than normal pregnant women, suggesting that this component of the innate immune system is involved in the mechanisms of disease in pre-eclampsia.
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Affiliation(s)
- Nandor Gabor Than
- Perinatology Research Branch, NICHD/NIH/DHHS, Wayne State University/Hutzel Women's Hospital, 3990 John R, Box 4, Detroit, MI 48201, USA.
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Christiansen OB, Nielsen HS, Lund M, Steffensen R, Varming K. Mannose-binding lectin-2 genotypes and recurrent late pregnancy losses. Hum Reprod 2009; 24:291-9. [DOI: 10.1093/humrep/den377] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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