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Isolation of Leukocytes from the Murine Tissues at the Maternal-Fetal Interface
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Complement-Mediated Disorders in Pregnancy

Kana Amari Chinchilla1, Madhusudan Vijayan1, Bruna Taveras Garcia1

  • 1Department of Nephrology/Medicine, Jacobi Medical Center at Albert Einstein College of Medicine, Bronx, NY.

Advances in Chronic Kidney Disease
|June 20, 2020
PubMed

Insights

Complement disorders in pregnancy involve all three pathways. Genetic variants in regulatory proteins increase risk for conditions like P-aHUS and HELLP, with eculizumab showing promise for maternal kidney outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Immunology
  • Nephrology

Background:

  • Complement-mediated disorders are implicated in various pregnancy complications, affecting classical, lectin, and alternative pathways.
  • Advances in understanding complement regulatory proteins (factor H, I, membrane cofactor protein, thrombomodulin) are crucial for the alternative pathway.
  • Genetic variants in these proteins predispose women to conditions like pregnancy-associated hemolytic uremic syndrome (P-aHUS) and HELLP syndrome.

Purpose of the Study:

  • To review the pathogenesis of complement-mediated pregnancy disorders.
  • To explore the role of complement genetic variants in disease phenotypes.
  • To summarize current experiences with eculizumab in managing these obstetric catastrophes.

Main Methods:

  • Review of current literature on complement pathways in pregnancy.
  • Analysis of genetic variants associated with complement-mediated obstetric conditions.
  • Synthesis of clinical data on eculizumab use in P-aHUS and HELLP.

Main Results:

  • Complement dysregulation contributes to diverse obstetric complications.
  • Specific genetic variants are linked to increased susceptibility to P-aHUS, HELLP, and other conditions.
  • Eculizumab has demonstrated potential in improving maternal renal outcomes in severe cases.

Conclusions:

  • Understanding complement pathways is vital for diagnosing and managing pregnancy disorders.
  • Genetic screening can identify at-risk individuals.
  • Targeted therapies like eculizumab offer new hope for severe complement-mediated obstetric conditions.

Keywords:
Alternative pathwayComplement genetic variantsComplement systemEculizumabPregnancy

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