Richard M Burwick1, Jesús A Velásquez, Catalina M Valencia, Jorge Gutiérrez-Marín, Francisco Edna-Estrada, Jaime L Silva, Juliana Trujillo-Otálvaro, Johanna Vargas-Rodríguez, Yamile Bernal, Alvaro Quintero, Mónica Rincón, Jorge E Tolosa. 1. Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon; the Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California; FUNDARED-MATERNA, Bogotá, Universidad de Antioquia, Hospital Universitario San Vicente Fundación, and Universidad de Antioquia, Departamento de Obstetricia y Ginecología, NACER Salud Sexual y Reproductiva, Medellín, Clínica Reina Sofía Colsanitas SA, Bogotá, Clínica Universitaria Bolivariana, Universidad Pontificia Bolivariana, Medellín, ESE Clínica de Maternidad Rafael Calvo, Grupo de Investigación Maternidad Segura, Universidad de Cartagena, Cartagena, Hospital Universitario San Ignacio, Departamento de Ginecología y Obstetricia, Pontificia Universidad Javeriana, Bogotá, Hospital General de Medellín, Luz Castro de Gutiérrez ESE, Hospital Universitario, Medellín, and Laboratorio Clínico Sanitas, Clínica Colsanitas SA, Grupo de Investigación INPAC, Bogotá, Colombia.
Abstract
OBJECTIVE: To evaluate whether C5b-9 concentrations in blood and urine are increased in preeclampsia with severe features. METHODS: The Complement and Preeclampsia in the Americas study is a prospective, multicenter case-control study performed at six centers in Colombia from November 2015 to July 2016. The case group included women with preeclampsia with severe features, and the control group included women who were healthy or had chronic hypertension, gestational hypertension, or preeclampsia without severe features. We enrolled two women in the control group for every woman in the case group. Soluble C5b-9 concentrations were measured by enzyme-linked immunosorbent assays in blood and urine. The primary outcome was C5b-9 concentrations in women in the case group compared with all women in the control group, and the secondary outcome was C5b-9 levels in women in the case group compared with individual control subgroups. Differences were assessed by test of medians, and associations were further evaluated by receiver operating characteristic curve analysis and logistic regression with α=0.05. RESULTS: Three hundred fifty-two patients were enrolled. Plasma C5b-9 concentrations did not differ significantly between women in the case group and those in the control group, but urine C5b-9 concentrations were higher in women in the case group (median [interquartile range] 9.9 [1.6-43.7] vs 1.8 [0.54-4.1] ng/mL, P<.001). In subgroup analysis, plasma C5b-9 concentrations were increased in women in the case group compared with healthy women in the control group (median [interquartile range] 2,778 [1,633-4,230] vs 1,374 [1,064-2,332] ng/mL, P<.001), and urine C5b-9 concentrations were increased in women in the case group compared with all control subgroups (P<.001). Using receiver operating characteristic analysis, urine C5b-9 concentrations differentiated preeclampsia with severe features from hypertensive women in the control group (area under the receiver operating characteristic curve 0.74, 95% CI 0.68-0.80). Urine C5b-9 22 ng/mL or greater (range 0-158.4 ng/mL) was the optimal cut point for diagnosis of preeclampsia with severe features with adjusted odds ratio of 10.0 (95% CI 3.5-28.8, P<.001). CONCLUSION: Urinary excretion of terminal complement effector C5b-9 is higher in women with preeclampsia with severe features compared with women with other hypertensive disorders of pregnancy and women without hypertension.
OBJECTIVE: To evaluate whether C5b-9 concentrations in blood and urine are increased in preeclampsia with severe features. METHODS: The Complement and Preeclampsia in the Americas study is a prospective, multicenter case-control study performed at six centers in Colombia from November 2015 to July 2016. The case group included women with preeclampsia with severe features, and the control group included women who were healthy or had chronic hypertension, gestational hypertension, or preeclampsia without severe features. We enrolled two women in the control group for every woman in the case group. Soluble C5b-9 concentrations were measured by enzyme-linked immunosorbent assays in blood and urine. The primary outcome was C5b-9 concentrations in women in the case group compared with all women in the control group, and the secondary outcome was C5b-9 levels in women in the case group compared with individual control subgroups. Differences were assessed by test of medians, and associations were further evaluated by receiver operating characteristic curve analysis and logistic regression with α=0.05. RESULTS: Three hundred fifty-two patients were enrolled. Plasma C5b-9 concentrations did not differ significantly between women in the case group and those in the control group, but urine C5b-9 concentrations were higher in women in the case group (median [interquartile range] 9.9 [1.6-43.7] vs 1.8 [0.54-4.1] ng/mL, P<.001). In subgroup analysis, plasma C5b-9 concentrations were increased in women in the case group compared with healthy women in the control group (median [interquartile range] 2,778 [1,633-4,230] vs 1,374 [1,064-2,332] ng/mL, P<.001), and urine C5b-9 concentrations were increased in women in the case group compared with all control subgroups (P<.001). Using receiver operating characteristic analysis, urine C5b-9 concentrations differentiated preeclampsia with severe features from hypertensivewomen in the control group (area under the receiver operating characteristic curve 0.74, 95% CI 0.68-0.80). Urine C5b-9 22 ng/mL or greater (range 0-158.4 ng/mL) was the optimal cut point for diagnosis of preeclampsia with severe features with adjusted odds ratio of 10.0 (95% CI 3.5-28.8, P<.001). CONCLUSION: Urinary excretion of terminal complement effector C5b-9 is higher in women with preeclampsia with severe features compared with women with other hypertensive disorders of pregnancy and women without hypertension.
Authors: Connor F Laule; Evan J Odean; Cameron R Wing; Kate M Root; Kendra J Towner; Cassandra M Hamm; Jeffrey S Gilbert; Sherry D Fleming; Jean F Regal Journal: Am J Physiol Heart Circ Physiol Date: 2019-08-09 Impact factor: 4.733
Authors: Ingrid Aneman; Dillan Pienaar; Sonja Suvakov; Tatjana P Simic; Vesna D Garovic; Lana McClements Journal: Front Immunol Date: 2020-08-18 Impact factor: 7.561
Authors: Thomas F McElrath; David E Cantonwine; Kathryn J Gray; Hooman Mirzakhani; Robert C Doss; Najmuddin Khaja; Malik Khalid; Gail Page; Brian Brohman; Zhen Zhang; David Sarracino; Kevin P Rosenblatt Journal: Sci Rep Date: 2020-10-21 Impact factor: 4.379