Urinary excretion of C5b-9 in severe preeclampsia tipping the balance of complement activation in pregnancy

Richard Burwick, Raina N. Fichorova, Hassan Y. Dawood, Hidemi S. Yamamoto, Bruce B. Feinberg

Research output: Contribution to journalArticle

49 Scopus citations


The complement cascade is activated in normal pregnancy, and excessive complement activation propagates the systemic inflammatory response in severe preeclampsia. Consequently, biomarkers of complement dysregulation may be useful for prediction or treatment of disease. Because renal damage with proteinuria is a characteristic pathological feature of preeclampsia, we hypothesized that complement markers in urine, rather than plasma, could better reflect complement dysregulation in disease. To investigate this, we performed a case-control study of pregnant women, enrolling 25 cases with severe preeclampsia, 25 controls with chronic hypertension, and 25 healthy controls without hypertension matched by gestational age and parity. Subjects were recruited from the Brigham and Women's Hospital from March 2012 to March 2013. Urine and blood samples were collected on the day of enrollment, with complement activation (C3a, C5a, and C5b-9) measured by ELISA. Severe preeclampsia was associated with marked elevations in urinary C5b-9 (median [interquartile range], 4.3 [1.2-15.1] ng/mL) relative to subjects with chronic hypertension (0 [0-0]) and healthy controls (0 [0-0]; P

Original languageEnglish (US)
Pages (from-to)1040-1045
Number of pages6
Issue number6
Publication statusPublished - 2013
Externally publishedYes



  • Complement system proteins
  • Eculizumab
  • Hellp syndrome
  • Preeclampsia
  • Pregnancy

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine(all)

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