Fragment Bb: evidence for activation of the alternative pathway of the complement system in pregnant women with acute pyelonephritis.

Abstract

OBJECTIVE:

Pyelonephritis during pregnancy is associated with a more severe course than in the non-pregnant state. This has been attributed to an increased susceptibility of pregnant women to microbial products. The complement system is part of innate immunity and its alternative pathway is activated mainly by microorganisms. The purpose of this study was to determine if activation of the alternative pathway of the complement system (determined by maternal fragment Bb concentrations) occurs in pregnant women with acute pyelonephritis.

METHODS:

This cross-sectional study included the following groups: (1) normal pregnant women (n=62) and (2) pregnant women with pyelonephritis (n=38). Maternal plasma fragment Bb concentrations were determined by ELISA. Non-parametric statistics were used for analyses.

RESULTS:

(1) Pregnant women with pyelonephritis had a higher median plasma concentration of fragment Bb than those with a normal pregnancy (1.3 μg/ml, IQR: 1.1-1.9 vs. 0.8 μg/ml, IQR: 0.7-0.9; p<0.001); (2) No significant differences were observed in the median maternal plasma concentration of fragment Bb between pregnant women with pyelonephritis who had a positive blood culture and those with a negative blood culture (1.4 μg/ml, IQR: 1.1-3.5 vs. 1.3 μg/ml, IQR: 1.1-1.9; p=0.2).

CONCLUSIONS:

Pregnant women with acute pyelonephritis have evidence of activation of the alternative pathway of the complement system, regardless of the presence or absence of a positive blood culture.

• Authors: Eleazar Soto, Roberto Romero, Edi Vaisbuch, Offer Erez, Shali Mazaki-Tovi, Juan Pedro Kusanovic, Zhong Dong, Tinnakorn Chaiworapongsa, Lami Yeo, Pooja Mittal, Sonia S Hassan
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 23 Issue 10 Pg. 1085-90 (Oct 2010) ISSN: 1476-4954 [Electronic] England
• PMID: 20218820 (Publication Type: Journal Article, Research Support, N.I.H., Intramural)

Chemical References

• Complement Factor B

Topics

• Adult
• Complement Factor B (analysis, immunology)
• Complement Pathway, Alternative (immunology)
• Cross-Sectional Studies
• Female
• Humans
• Pregnancy
• Pregnancy Complications, Infectious (blood, immunology)
• Pyelonephritis (blood, complications, immunology)
• Young Adult