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ORIGINAL RESEARCH |
From the Departments of Pediatric Research and Obstetrics and Gynecology, Institute of Immunology, The National Hospital, University of Oslo, Oslo, Norway; Department of Immunology and Transfusion Medicine, Nordland Central Hospital, Bodø, and University of Tromsø, Tromsø, Norway; Laboratory for Experimental and Clinical Immunology, University of Amsterdam, Amsterdam, The Netherlands; and Department of Immunology and Transfusion Medicine, Institute of Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Address reprint requests to: Jan Roar Mellembakken, MD, Department of Obstetrics and Gynecology, National Hospital, 0027 Oslo, Norway, E-mail: jan.mellembakken{at}rikshospitalet.no
Objective: To investigate whether neutrophils and systemic complement are activated in pregnancies complicated by preeclampsia more than in normal pregnancies.
Methods: We measured native complement components and activation products in plasma by enzyme immunoassays in 19 women with uncomplicated pregnancies, 15 with preeclampsia before cesarean deliveries, and 16 nonpregnant women. Neutrophil activation was measured by specific enzyme immunoassays for myeloperoxidase and lactoferrin.
Results: Myeloperoxidase was significantly higher in women with preeclampsia (197 µg/L, 95% confidence interval [CI] 94, 646) than in women with uncomplicated pregnancies (124 µg/L, 95% CI 70, 289; P = .009), whereas lactoferrin did not differ between groups. C4 was decreased in preeclamptic women (0.16 g/L, 95% CI 0.07, 0.48) compared with women with uncomplicated pregnancies (0.21, 95% CI 0.10, 0.30, P < .001). There were no differences for the other native complement components. There was a significant decrease in C1rs-C1 inhibitor, 13 AU/mL (95% CI 9, 34) versus 19 (95% CI 13, 38) (P 
.001) in normal pregnant women compared with nonpregnant women. There also was an increase in C3, C4, C9 (data not shown), C4bp, 132% (95% CI 94%, 161%) versus 91% (95% CI 57%, 128%); C3bc (7.4 AU/mL, 95% CI 4.2, 10.7) versus 4.8 AU/mL (95% CI 3.2, 7.3) and C4bc (8.6 AU/mL, 95% CI 5.7, 14.0) versus 3.5 AU/mL (95% CI 2.2, 6.7) in normal pregnant women compared with nonpregnant women (P .001).
Conclusion: Neutrophil activation in preeclampsia was shown by systemic increases in myeloperoxidase. Except for a decrease in C4, systemic complement activation could not be detected in preeclampsia.
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