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

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

Research output: Contribution to journalArticlepeer-review

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 (n62) and (2) pregnant women with pyelonephritis (n38). 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 (1.3μg/ml, IQR: 1.11.9 vs. 0.8μg/ml, IQR: 0.70.9; 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 (1.4μg/ml, IQR: 1.13.5 vs. 1.3μg/ml, IQR: 1.11.9; p0.2). 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.

Original languageEnglish
Pages (from-to)1085-1090
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume23
Issue number10
DOIs
StatePublished - Oct 2010
Externally publishedYes

Keywords

  • Acute respiratory distress syndrome
  • Th1/Th2
  • asymptomatic bacteriuria
  • inflammation
  • innate immunity
  • pregnancy
  • urinary tract infection

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