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The Complement System in the Pathophysiology of Pregnancy and in Systemic Autoimmune Rheumatic Diseases During Pregnancy

The complement system plays a double role in pregnancy exerting both protective and damaging effects at placental level. Complement activation at fetal-maternal interface participates in protection against infectious agents and helps remove apoptotic and necrotic cells. Locally synthesized C1q contr...

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Autores principales: Chighizola, Cecilia Beatrice, Lonati, Paola Adele, Trespidi, Laura, Meroni, Pier Luigi, Tedesco, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481445/
https://www.ncbi.nlm.nih.gov/pubmed/32973817
http://dx.doi.org/10.3389/fimmu.2020.02084
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author Chighizola, Cecilia Beatrice
Lonati, Paola Adele
Trespidi, Laura
Meroni, Pier Luigi
Tedesco, Francesco
author_facet Chighizola, Cecilia Beatrice
Lonati, Paola Adele
Trespidi, Laura
Meroni, Pier Luigi
Tedesco, Francesco
author_sort Chighizola, Cecilia Beatrice
collection PubMed
description The complement system plays a double role in pregnancy exerting both protective and damaging effects at placental level. Complement activation at fetal-maternal interface participates in protection against infectious agents and helps remove apoptotic and necrotic cells. Locally synthesized C1q contributes to the physiologic vascular remodeling of spiral arteries characterized by loss of smooth muscle cells and transformation into large dilated vessels. Complement activation triggered by the inflammatory process induced by embryo implantation can damage trophoblast and other decidual cells that may lead to pregnancy complications if the cells are not protected by the complement regulators CD55, CD46, and CD59 expressed on cell surface. However, uncontrolled complement activation induces placental alterations resulting in adverse pregnancy outcomes. This may occur in pathological conditions characterized by placental localization of complement fixing antibodies directed against beta2-glycoprotein 1, as in patients with anti-phospholipid syndrome, or circulating immune complexes deposited in placenta, as in patients with systemic lupus erythematosus. In other diseases, such as preeclampsia, the mechanism of complement activation responsible for complement deposits in placenta is unclear. Conflicting results have been reported on the relevance of complement assays as diagnostic and prognostic tools to assess complement involvement in pregnant patients with these disorders.
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spelling pubmed-74814452020-09-23 The Complement System in the Pathophysiology of Pregnancy and in Systemic Autoimmune Rheumatic Diseases During Pregnancy Chighizola, Cecilia Beatrice Lonati, Paola Adele Trespidi, Laura Meroni, Pier Luigi Tedesco, Francesco Front Immunol Immunology The complement system plays a double role in pregnancy exerting both protective and damaging effects at placental level. Complement activation at fetal-maternal interface participates in protection against infectious agents and helps remove apoptotic and necrotic cells. Locally synthesized C1q contributes to the physiologic vascular remodeling of spiral arteries characterized by loss of smooth muscle cells and transformation into large dilated vessels. Complement activation triggered by the inflammatory process induced by embryo implantation can damage trophoblast and other decidual cells that may lead to pregnancy complications if the cells are not protected by the complement regulators CD55, CD46, and CD59 expressed on cell surface. However, uncontrolled complement activation induces placental alterations resulting in adverse pregnancy outcomes. This may occur in pathological conditions characterized by placental localization of complement fixing antibodies directed against beta2-glycoprotein 1, as in patients with anti-phospholipid syndrome, or circulating immune complexes deposited in placenta, as in patients with systemic lupus erythematosus. In other diseases, such as preeclampsia, the mechanism of complement activation responsible for complement deposits in placenta is unclear. Conflicting results have been reported on the relevance of complement assays as diagnostic and prognostic tools to assess complement involvement in pregnant patients with these disorders. Frontiers Media S.A. 2020-08-27 /pmc/articles/PMC7481445/ /pubmed/32973817 http://dx.doi.org/10.3389/fimmu.2020.02084 Text en Copyright © 2020 Chighizola, Lonati, Trespidi, Meroni and Tedesco. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Chighizola, Cecilia Beatrice
Lonati, Paola Adele
Trespidi, Laura
Meroni, Pier Luigi
Tedesco, Francesco
The Complement System in the Pathophysiology of Pregnancy and in Systemic Autoimmune Rheumatic Diseases During Pregnancy
title The Complement System in the Pathophysiology of Pregnancy and in Systemic Autoimmune Rheumatic Diseases During Pregnancy
title_full The Complement System in the Pathophysiology of Pregnancy and in Systemic Autoimmune Rheumatic Diseases During Pregnancy
title_fullStr The Complement System in the Pathophysiology of Pregnancy and in Systemic Autoimmune Rheumatic Diseases During Pregnancy
title_full_unstemmed The Complement System in the Pathophysiology of Pregnancy and in Systemic Autoimmune Rheumatic Diseases During Pregnancy
title_short The Complement System in the Pathophysiology of Pregnancy and in Systemic Autoimmune Rheumatic Diseases During Pregnancy
title_sort complement system in the pathophysiology of pregnancy and in systemic autoimmune rheumatic diseases during pregnancy
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481445/
https://www.ncbi.nlm.nih.gov/pubmed/32973817
http://dx.doi.org/10.3389/fimmu.2020.02084
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