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Complement Pathway and Endothelial Dysfunction in Severe Preeclampsia

1Josep Carreras Leukaemia Research Institute, Barcelona, Spain, 2Hospital Clinic, Nephrology and Renal Transplantation Department, Barcelona, Spain, 3Hospital Clinic, BCNatal, Fetal Medicine Research Center, Barcelona, Spain, 4Hospital Clinic, Hematopathology, Centre Diagnòstic Biomèdic (CDB), Barcelona, Spain, 5Hospital Clinic, Barcelona Hepatic Hemodynamic Laboratory, Barcelona, Spain

Abstract Number: PB1945

Meeting: ISTH 2020 Congress

Theme: Thrombotic Microangiopathies » Non HUS/TTP Microangiopathies

Background: Severe preeclampsia is a complication of pregnancy characterized by high blood pressure and damage to kidneys, liver and brain that lead to complications for mother and baby. Complement system could be abnormally activated in preeclampsia and lead to endothelial dysfunction.

Aims: To evaluate in vitro the endothelial function in women with severe preeclampsia (n=9) and assess the functionality of the complement system in both maternal (n=4) and fetal samples (n=4) compared to control mothers and fetuses matched by gestational age.

Methods: Endothelial dysfunction markers (ICAM-1 and vWF) were evaluated in endothelial cells (ECs) in culture exposed to sera from severe preeclampsia patients. Complement activation was assessed by exposing EC to patient’s plasma samples mixed with control serum (1:1). C5b9 deposits on EC were analyzed through immunofluorescence and expressed as fold increase vs. control samples.

Results: Expression of endothelial markers of dysfunction was increased in ECs exposed to severe preeclampsia patients serum (figure 1) and that an anomalous enhanced activity of the complement pathway is present in these patients (figure 2). Moreover, significant reduced activity of the terminal phase of the complement pathway in the fetal plasma samples from severe preeclampsia pregnancies when compared to healthy ones.

Conclusions: Severe preeclampsia is associated with endothelial dysfunction and an abnormal activation of the complement pathway. Given the high morbidity and mortality associated with this complication, any therapeutic strategy focused to prevent maternal complications and prolong pregnancy would have a clear benefit for the health of mothers and fetuses. Our present results could be useful in the search for therapeutic targets.


[Figure 2: Representative microphotographs of the C5b-9 deposit (red) on endothelial cell in vitro (blue-labeled nuclei)]

To cite this abstract in AMA style:

Palomo M, Blasco M, Crispi F, Torramade-Moix S, Molina P, Campistol JM, Garcia Pagan JC, Gratacos E, Escolar G, Diaz-Ricart M. Complement Pathway and Endothelial Dysfunction in Severe Preeclampsia [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/complement-pathway-and-endothelial-dysfunction-in-severe-preeclampsia/. Accessed September 21, 2023.

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