Terminal Complement Activation in Preeclampsia
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 201...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 2018-12, Vol.132 (6), p.1477-1485 |
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| creator | Burwick, Richard M. 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 E. |
| description | 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 |
| doi_str_mv | 10.1097/AOG.0000000000002980 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1097_AOG_0000000000002980</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>30399106</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5130-3d0e1470c167ef80b5d129ab6b6da1a33dfba2aa13e501998b2a25ae7139b7543</originalsourceid><addsrcrecordid>eNqFj91Kw0AQRhdRbK2-gUheIHVmN8lmL0vRKhT0ooJ3YZJMaHTzwya1-PYmVEW80LkZZvjOB0eIS4Q5gtHXi4fVHH6MNDEciSnGWvlSqedjMR2fvo6DYCLOuu5lCGFk1KmYKFDGIERTMd-wq8qarLdsqtZyxXXvLbK-fKO-bGqvrL1Hx5xZqtqupHNxUpDt-OJzz8TT7c1meeevH1b3y8Xaz0JU4KscGAMNGUaaixjSMEdpKI3SKCckpfIiJUmEikNAY-JUkgyJNSqT6jBQMxEcejPXdJ3jImldWZF7TxCSUT8Z9JPf-gN2dcDaXVpx_g19-Q6B-BDYN7Zn173a3Z5dsmWy_fa_7uAPdIxFMgRfAsYoh8sfQak-ACywdSs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Terminal Complement Activation in Preeclampsia</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Burwick, Richard M. ; 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 E.</creator><creatorcontrib>Burwick, Richard M. ; 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 E.</creatorcontrib><description>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.</description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/AOG.0000000000002980</identifier><identifier>PMID: 30399106</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Adult ; Area Under Curve ; Case-Control Studies ; Complement Activation ; Complement Membrane Attack Complex - metabolism ; Complement Membrane Attack Complex - urine ; Female ; Humans ; Hypertension - blood ; Hypertension - urine ; Pre-Eclampsia - blood ; Pre-Eclampsia - diagnosis ; Pre-Eclampsia - urine ; Pregnancy ; Prospective Studies ; ROC Curve ; Severity of Illness Index ; Young Adult</subject><ispartof>Obstetrics and gynecology (New York. 1953), 2018-12, Vol.132 (6), p.1477-1485</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5130-3d0e1470c167ef80b5d129ab6b6da1a33dfba2aa13e501998b2a25ae7139b7543</citedby><cites>FETCH-LOGICAL-c5130-3d0e1470c167ef80b5d129ab6b6da1a33dfba2aa13e501998b2a25ae7139b7543</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30399106$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Burwick, Richard M.</creatorcontrib><creatorcontrib>Velásquez, Jesús A.</creatorcontrib><creatorcontrib>Valencia, Catalina M.</creatorcontrib><creatorcontrib>Gutiérrez-Marín, Jorge</creatorcontrib><creatorcontrib>Edna-Estrada, Francisco</creatorcontrib><creatorcontrib>Silva, Jaime L.</creatorcontrib><creatorcontrib>Trujillo-Otálvaro, Juliana</creatorcontrib><creatorcontrib>Vargas-Rodríguez, Johanna</creatorcontrib><creatorcontrib>Bernal, Yamile</creatorcontrib><creatorcontrib>Quintero, Alvaro</creatorcontrib><creatorcontrib>Rincón, Mónica</creatorcontrib><creatorcontrib>Tolosa, Jorge E.</creatorcontrib><title>Terminal Complement Activation in Preeclampsia</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>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.</description><subject>Adult</subject><subject>Area Under Curve</subject><subject>Case-Control Studies</subject><subject>Complement Activation</subject><subject>Complement Membrane Attack Complex - metabolism</subject><subject>Complement Membrane Attack Complex - urine</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - blood</subject><subject>Hypertension - urine</subject><subject>Pre-Eclampsia - blood</subject><subject>Pre-Eclampsia - diagnosis</subject><subject>Pre-Eclampsia - urine</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>ROC Curve</subject><subject>Severity of Illness Index</subject><subject>Young Adult</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFj91Kw0AQRhdRbK2-gUheIHVmN8lmL0vRKhT0ooJ3YZJMaHTzwya1-PYmVEW80LkZZvjOB0eIS4Q5gtHXi4fVHH6MNDEciSnGWvlSqedjMR2fvo6DYCLOuu5lCGFk1KmYKFDGIERTMd-wq8qarLdsqtZyxXXvLbK-fKO-bGqvrL1Hx5xZqtqupHNxUpDt-OJzz8TT7c1meeevH1b3y8Xaz0JU4KscGAMNGUaaixjSMEdpKI3SKCckpfIiJUmEikNAY-JUkgyJNSqT6jBQMxEcejPXdJ3jImldWZF7TxCSUT8Z9JPf-gN2dcDaXVpx_g19-Q6B-BDYN7Zn173a3Z5dsmWy_fa_7uAPdIxFMgRfAsYoh8sfQak-ACywdSs</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Burwick, Richard M.</creator><creator>Velásquez, Jesús A.</creator><creator>Valencia, Catalina M.</creator><creator>Gutiérrez-Marín, Jorge</creator><creator>Edna-Estrada, Francisco</creator><creator>Silva, Jaime L.</creator><creator>Trujillo-Otálvaro, Juliana</creator><creator>Vargas-Rodríguez, Johanna</creator><creator>Bernal, Yamile</creator><creator>Quintero, Alvaro</creator><creator>Rincón, Mónica</creator><creator>Tolosa, Jorge E.</creator><general>Lippincott Williams & Wilkins</general><general>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20181201</creationdate><title>Terminal Complement Activation in Preeclampsia</title><author>Burwick, Richard M. ; 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 E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5130-3d0e1470c167ef80b5d129ab6b6da1a33dfba2aa13e501998b2a25ae7139b7543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Area Under Curve</topic><topic>Case-Control Studies</topic><topic>Complement Activation</topic><topic>Complement Membrane Attack Complex - metabolism</topic><topic>Complement Membrane Attack Complex - urine</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - blood</topic><topic>Hypertension - urine</topic><topic>Pre-Eclampsia - blood</topic><topic>Pre-Eclampsia - diagnosis</topic><topic>Pre-Eclampsia - urine</topic><topic>Pregnancy</topic><topic>Prospective Studies</topic><topic>ROC Curve</topic><topic>Severity of Illness Index</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Burwick, Richard M.</creatorcontrib><creatorcontrib>Velásquez, Jesús A.</creatorcontrib><creatorcontrib>Valencia, Catalina M.</creatorcontrib><creatorcontrib>Gutiérrez-Marín, Jorge</creatorcontrib><creatorcontrib>Edna-Estrada, Francisco</creatorcontrib><creatorcontrib>Silva, Jaime L.</creatorcontrib><creatorcontrib>Trujillo-Otálvaro, Juliana</creatorcontrib><creatorcontrib>Vargas-Rodríguez, Johanna</creatorcontrib><creatorcontrib>Bernal, Yamile</creatorcontrib><creatorcontrib>Quintero, Alvaro</creatorcontrib><creatorcontrib>Rincón, Mónica</creatorcontrib><creatorcontrib>Tolosa, Jorge E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Burwick, Richard M.</au><au>Velásquez, Jesús A.</au><au>Valencia, Catalina M.</au><au>Gutiérrez-Marín, Jorge</au><au>Edna-Estrada, Francisco</au><au>Silva, Jaime L.</au><au>Trujillo-Otálvaro, Juliana</au><au>Vargas-Rodríguez, Johanna</au><au>Bernal, Yamile</au><au>Quintero, Alvaro</au><au>Rincón, Mónica</au><au>Tolosa, Jorge E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Terminal Complement Activation in Preeclampsia</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>132</volume><issue>6</issue><spage>1477</spage><epage>1485</epage><pages>1477-1485</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><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.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>30399106</pmid><doi>10.1097/AOG.0000000000002980</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0029-7844 |
| ispartof | Obstetrics and gynecology (New York. 1953), 2018-12, Vol.132 (6), p.1477-1485 |
| issn | 0029-7844 1873-233X |
| language | eng |
| recordid | cdi_crossref_primary_10_1097_AOG_0000000000002980 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Area Under Curve Case-Control Studies Complement Activation Complement Membrane Attack Complex - metabolism Complement Membrane Attack Complex - urine Female Humans Hypertension - blood Hypertension - urine Pre-Eclampsia - blood Pre-Eclampsia - diagnosis Pre-Eclampsia - urine Pregnancy Prospective Studies ROC Curve Severity of Illness Index Young Adult |
| title | Terminal Complement Activation in Preeclampsia |
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