Adipsin of the Alternative Complement Pathway Is a Potential Predictor for Preeclampsia in Early Pregnancy.

Min Liu,Xiaolei Luo,Linbo Gao,Hongbiao Yu,Qin Xu,Rong Zhou,Tao Wang

doi:10.3389/fimmu.2021.702385

Abstract

ObjectiveThe concentrations of complement proteins (adipsin, C3a, and C5a) and soluble endoglin (sENG) in the plasma were measured in this study, and their value as early-pregnancy predictors and potential diagnostic marker of preeclampsia was assessed, respectively.Experimental DesignPlasma samples were obtained from healthy and preeclampsia pregnant women before delivery for a cross-sectional study. Plasma samples were collected from healthy and preeclampsia pregnant women throughout pregnancy and postpartum for a follow-up study. Enzyme-linked immunosorbent assays were used to detect plasma levels of several complement proteins (adipsin, C3a, and C5a) and sENG.ResultsThe plasma levels of adipsin, C5a, and sENG were significantly increased before delivery in pregnant women with preeclampsia. During pregnancy, the plasma adipsin, C5a, and sENG levels were increased from the third trimester in healthy pregnant women; plasma adipsin levels remained stable after delivery, while C3a levels increased in the second trimester and remained stable afterward. Furthermore, levels of adipsin, C5a, and sENG were higher in preeclampsia patients at different stages of pregnancy; the C3a level presents a similar change and no difference was found in the third trimester. In the first trimester, receiver-operating curve (ROC) curve analysis showed that adipsin (AUC, 0.83 ± 0.06, P=0.001) and sENG (AUC, 0.74 ± 0.09, P=0.021) presented high value as predictors of early pregnancy.ConclusionsAdipsin is likely a novel plasma biomarker to monitor the increased risk of preeclampsia in early pregnancy. Moreover, the increased plasma levels of adipsin, C5a, and sENG before delivery may be associated with preeclampsia.

Highlights

Preeclampsia is a pregnancy complication mainly characterized by gestational hypertension, proteinuria, systemic endothelial cell activation, and inflammatory overreaction [1]
Our previous study found that the adipsin levels were significantly elevated in the plasma of patients with preeclampsia, and the urinary adipsin concentration appeared to be a good biomarker for the diagnosis of preeclampsia [10]
Preeclampsia is defined new onset of hypertension present after 20 weeks of gestation combined with systolic blood pressure (BP) ≥140 mm Hg or diastolic BP ≥90 mm Hg on two occasions at least 4 hours apart while the patient is on bed rest, or proteinuria of ≥0.3 g in a 24-h urine specimen

Summary

Introduction

Preeclampsia is a pregnancy complication mainly characterized by gestational hypertension, proteinuria, systemic endothelial cell activation, and inflammatory overreaction [1]. Recent studies have found that dysregulation of the complement system contributed to the pathogenesis of preeclampsia (reviewed in [5]). Known as complement Factor D, is expressed and secreted at high levels by adipose tissue and is a key molecule in the alternative pathway [8]. Natalia et al reported that levels of adipsin were significantly elevated in pregnant women with preeclampsia in the last trimester [9]. Our previous study found that the adipsin levels were significantly elevated in the plasma of patients with preeclampsia, and the urinary adipsin concentration appeared to be a good biomarker for the diagnosis of preeclampsia [10]. We hypothesized that changes in plasma adipsin levels might be valuable for prediction or diagnosis

Methods

Results

Conclusion