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Complement activation, a threat to pregnancy

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Abstract

Pregnancy poses a challenge for the immune systems of placental mammals. As fetal tissues are semi-allogeneic and alloantibodies that commonly develop in the mother, the fetus and the placenta might be subject to complement-mediated immune attack with the potential risk of adverse pregnancy outcomes. Here, I describe how the use of animal models was pivotal in demonstrating that complement inhibition at the fetomaternal interface is essential for a successful pregnancy. Studies in animals also helped the identification of uncontrolled complement activation as a crucial effector in the pathogenesis of recurrent miscarriages, intrauterine growth restriction, preeclampsia, and preterm birth. Clinical studies employing complement biomarkers in plasma and urine showed an association between dysregulation of the complement system and adverse pregnancy outcomes. A better understanding of the role of the complement system in pregnancy complications will allow a rational approach to manipulate its activation as a potential therapeutic strategy with the goal of protecting pregnancies and improving long-term outcomes for mother and child.

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  1. Pregnancy Laboratory, Department of Women and Children’s Health, The Rayne Institute, St Thomas’ Hospital, King’s College London, London, SE1 7EH, UK

    Guillermina Girardi

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  1. Guillermina Girardi
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Correspondence to Guillermina Girardi.

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This article is a contribution to the special issue on Complement in Health and Disease: Novel Aspects and Insights – Guest Editors: Paul Morgan and David Kavanagh

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Girardi, G. Complement activation, a threat to pregnancy. Semin Immunopathol 40, 103–111 (2018). https://doi.org/10.1007/s00281-017-0645-x

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