THE ROLE OF ANGIOGENIC AND IMMUNOLOGICAL FACTORS IN PREECLAMPSIA
Derzsy Zoltán
KÁROLY RÁCZ CONSERVATIVE MEDICINE PROGRAM
Dr. Reusz György
SE Szülészeti és Nőgyógyászati Klinika, Baross utcai részleg
2025-06-26 12:00:00
Reproductive medicine
Dr. Rigó János
Dr. Molvarec Attila
Dr. Pozsonyi Zoltán
Dr. Szigeti Zsanett
Dr. Farkas Henriett
Dr. Pulay Attila
Dr. Fekete Tibor
We investigated the activity of the plasma von Willebrand factor cleaving protease (ADAMTS13), von Willebrand factor (VWF) antigen levels, and the structure of von Willebrand factor multimers in preeclampsia. Additionally, we aimed to analyze the systemic activation of the complement system via the classical, lectin, and alternative pathways in preeclampsia. We found no significant differences in plasma ADAMTS13 activity among the three groups studied: preeclamptic pregnant women, healthy pregnant women, and healthy non-pregnant women. The plasma levels of von Willebrand factor antigen were significantly higher in preeclamptic pregnant women compared to healthy pregnant and non-pregnant women. We also examined the multimer structure of von Willebrand factor in 5 preeclamptic women, 5 healthy pregnant women, and 5 healthy non-pregnant women, matched for age, gestational age, and smoking status. The multimer structure of von Willebrand factor was intact in all groups, with no significant differences in the percentage of large multimers among the preeclamptic, healthy pregnant, and healthy non-pregnant women.
Our study on the activation of the complement system showed that the levels of CRP, C4d, C3a, SC5b9, C3, C9 and factor H antigen were significantly higher, while those of C1-inhibitor were significantly lower in healthy pregnant than non-pregnant women. In addition, preeclamptic patients had significantly higher CRP, C4d, C3a, SC5b9 levels and significantly lower C3 concentrations as compared to healthy pregnant women. Their CRP, C4d, C3a, SC5b9, C4, C3, C9 and factor H antigen levels were significantly higher, while C1-inhibitor concentrations were significantly lower compared with healthy non-pregnant women. Preeclamptic patients with fetal growth restriction had significantly higher plasma SC5b9 levels than those without IUGR.
Activation of the classical or lectin pathway(C4d) showed significant positive correlation to C3 activation (C3a) both in healthy pregnant women and preeclamptic patients. In our further study we could prove the subordinate role of the lectin pathway, indicating systemic activation of the complement system via the classical pathway, leading to increased formation of the terminal complex (SC5b9). The excessive amount of the terminal complex in the maternal circulation was associated with intrauterine growth restriction in preeclamptic pregnancies
