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Serum Levels of Collectins Are Sustained During Pregnancy: Surfactant Protein D Levels Are Dysregulated Prior to Missed Abortion

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Abstract

About 15% of pregnant women undergo missed abortion (MA), wherein women do not experience cramping and vaginal bleeding. Dysregulation of the immune molecules and steroid hormones contribute to early pregnancy loss. Collectins- surfactant protein A (SP-A), surfactant protein D (SP-D), and mannose-binding lectin (MBL) are a group of innate immune molecules regulated by the steroid hormones. Reduced levels of SP-A and SP-D during the early gestation exhibited a significant association with the severe early onset preeclampsia. In order to determine the serum profile of collectins throughout the normal pregnancy and explore their predictive potential during the 8–12 weeks of gestation for MA, we examined a prospective cohort of pregnant women (n = 221). The serum levels of SP-A and SP-D were significantly downregulated in the normal pregnant women in all the three trimesters (n = 30) compared with the non-pregnant women (n = 20) and were not significantly different across the three trimesters. Fourteen of the women from the cohort underwent MA during the 14–20 weeks of gestation and exhibited a significant downregulation in the serum levels of SP-D during 8–12 weeks of gestation. A significant inhibition of the HTR-8/SVneo cell proliferation and migration in the presence of a recombinant fragment of human SP-D suggested the relevance of SP-D in placental development. We report here that the serum levels of SP-A, SP-D, and MBL are consistently maintained during pregnancy in the Indian cohort. Dysregulated serum levels of SP-D and P4/E2 ratio during the early first trimester may predict occurrence of MA.

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Acknowledgments

We thank Dr. Smita Mahale, Director, ICMR-National Institute for Research in Reproductive Health, for providing the financial support and experimental facilities to carry out the study (Accession No. RA/636/05-2018). Authors are thankful to Dr. Shahina Begum, ICMR-NIRRH for her valuable suggestions regarding the appropriate statistical tests for the study. We are grateful to Mr. Vaibhav Shinde, graphics expert, NIRRH, for his help in improving the resolution of figures. KK acknowledges the ICMR-NIRRH and ICMR for providing Junior and Senior Research Fellowships. We are grateful to all the women participants for their contribution to the study.

Funding

The authors received financial support from ICMR-National Institute for Research in Reproductive Health to carry out the study (Accession No. RA/636/05-2018). SA was funded by Researchers Supporting Project (RSP-2020/26) King Saud University, Riyadh, Saudi Arabia.

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Authors and Affiliations

  1. Department of Innate Immunity, ICMR-National Institute for Research in Reproductive Health, J.M. Street, Parel, Mumbai, Maharashtra, 400012, India

    Kavita Kale & Taruna Madan

  2. Department of Obstetrics and Gynaecology, DY Patil Medical College, Hospital and Research Centre, Nerul, Navi Mumbai, Maharashtra, India

    Pallavi Vishwekar & Ganpat Sawant

  3. Department of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Parel, Mumbai, Maharashtra, India

    Geetha Balsarkar & M. J. Jassawalla

  4. Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia

    Saad Alkahtani

  5. Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK

    Uday Kishore

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  1. Kavita Kale
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Correspondence to Taruna Madan.

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Serum samples were obtained with written informed consent of the participants, and the protocol was approved by the Institutional Ethical Committee of Indian Council of Medical Research-National Institute for Research in Reproductive Health (ICMR-NIRRH), Mumbai (No. 276/2015), Ethics Committee for Research on Human Subjects of DY Patil Hospital, Nerul, Navi Mumbai (PDYPMC/Ethics/2015), and Wadia Maternity Hospital, Parel, Mumbai (IEC-NWMH/AP/2015/003-version 2).

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Kale, K., Vishwekar, P., Balsarkar, G. et al. Serum Levels of Collectins Are Sustained During Pregnancy: Surfactant Protein D Levels Are Dysregulated Prior to Missed Abortion. Reprod. Sci. 27, 1894–1908 (2020). https://doi.org/10.1007/s43032-020-00209-3

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