Terminal Complement Activation in Preeclampsia

Richard Burwick, 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 Tolosa

Research output: Contribution to journalArticle

5 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1477-1485
Number of pages9
JournalObstetrics and Gynecology
Volume132
Issue number6
DOIs
StatePublished - Dec 1 2018

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Complement Activation
Pre-Eclampsia
Complement Membrane Attack Complex
Urine
Control Groups
ROC Curve
Complement C5b
Hypertension
Pregnancy Induced Hypertension
Colombia

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Burwick, R., Velásquez, J. A., Valencia, C. M., Gutiérrez-Marín, J., Edna-Estrada, F., Silva, J. L., ... Tolosa, J. (2018). Terminal Complement Activation in Preeclampsia. Obstetrics and Gynecology, 132(6), 1477-1485. https://doi.org/10.1097/AOG.0000000000002980

Terminal Complement Activation in Preeclampsia. / Burwick, Richard; Velásquez, Jesús A.; Valencia, Catalina M.; Gutiérrez-Marín, Jorge; Edna-Estrada, Francisco; Silva, Jaime L.; Trujillo-Otálvaro, Juliana; Vargas-Rodríguez, Johanna; Bernal, Yamile; Quintero, Alvaro; Rincón, Mónica; Tolosa, Jorge.

In: Obstetrics and Gynecology, Vol. 132, No. 6, 01.12.2018, p. 1477-1485.

Research output: Contribution to journalArticle

Burwick, R, Velásquez, JA, Valencia, CM, Gutiérrez-Marín, J, Edna-Estrada, F, Silva, JL, Trujillo-Otálvaro, J, Vargas-Rodríguez, J, Bernal, Y, Quintero, A, Rincón, M & Tolosa, J 2018, 'Terminal Complement Activation in Preeclampsia', Obstetrics and Gynecology, vol. 132, no. 6, pp. 1477-1485. https://doi.org/10.1097/AOG.0000000000002980
Burwick R, Velásquez JA, Valencia CM, Gutiérrez-Marín J, Edna-Estrada F, Silva JL et al. Terminal Complement Activation in Preeclampsia. Obstetrics and Gynecology. 2018 Dec 1;132(6):1477-1485. https://doi.org/10.1097/AOG.0000000000002980
Burwick, Richard ; Velásquez, Jesús A. ; Valencia, Catalina M. ; Gutiérrez-Marín, Jorge ; Edna-Estrada, Francisco ; Silva, Jaime L. ; Trujillo-Otálvaro, Juliana ; Vargas-Rodríguez, Johanna ; Bernal, Yamile ; Quintero, Alvaro ; Rincón, Mónica ; Tolosa, Jorge. / Terminal Complement Activation in Preeclampsia. In: Obstetrics and Gynecology. 2018 ; Vol. 132, No. 6. pp. 1477-1485.
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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.",
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T1 - Terminal Complement Activation in Preeclampsia

AU - Burwick, Richard

AU - Velásquez, Jesús A.

AU - Valencia, Catalina M.

AU - Gutiérrez-Marín, Jorge

AU - Edna-Estrada, Francisco

AU - Silva, Jaime L.

AU - Trujillo-Otálvaro, Juliana

AU - Vargas-Rodríguez, Johanna

AU - Bernal, Yamile

AU - Quintero, Alvaro

AU - Rincón, Mónica

AU - Tolosa, Jorge

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N2 - 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.

AB - 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.

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