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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2021№6
The complement system during physiological...

The complement system during physiological pregnancy

DOI
https://dx.doi.org/10.18565/aig.2021.6.14-20

Sidorova I.S., Nikitina N.A., Unanyan A.L., Ageev M.B., Kokin  A.A.

1) Obstetrics and Gynecology Department No 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of the Russian Federation, Moscow, Russia; 2) Intensive Care Unit, Branch (Maternity Hospital), V.V. Veresaev City Clinical Hospital, Moscow Healthcare Department, Moscow, Russia
This literature review analyzes the studies published over the past 10 years on the role of the complement system in the physiological development of pregnancy. The complement system belongs to the factors of innate immunity and plays an important role in maintaining homeostasis and developing a normal pregnancy. The paper presents the currently available data on changes in complement factors from preimplantation to full term. Many authors recognize that normal pregnancy develops after the moderate activation of the system of the complement, which is accompanied by the higher expression of its regulatory proteins in both maternal blood flow and the placenta. By the end of the third trimester, there are increases in the concentration of C3, C4d, C9, sC5b-9, anaphylatoxins C3a, C4a, C5a, regulatory factor H, as well as the C4d/C4, C3a/C3 ratios. Adequate placentation is accompanied by local expression of regulatory proteins, such as DAF (CD55), CD59, and MCP (CD46), which block the formation of C3 and C5 convertases and the assembly of MAC on the cell membrane surface. In addition, the investigators studied the role of the complement system in the processes of implantation and placentation, development of fetal organs and systems, and preparation for childbirth, as well as the risk of pregnancy complications and postnatal diseases in both the mother and her baby when complementary homeostasis is disrupted.
Conclusion. Clinical trials using complement biomarkers in serum, urine, and placenta have shown a direct relationship between complement system dysregulation and adverse pregnancy outcomes, such as preeclampsia, fetal growth retardation, miscarriage, and preterm birth.

Keywords

complement system
complement activation
pregnancy
placentation
neurogenesis
Full text (in Russian)

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Received 12.03.2021

Accepted 02.04.2021

About the Authors

Iraida S. Sidorova, Dr. Med. Sci., Professor, Academician of the RAS, Merited Scholar of the Russian Federation, Department of Obstetrics and Gynecology № 1,
N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University). E-mail: sidorovais@yandex.ru.
ORCID: 0000-0003-2209-8662. 119991, Russia, Moscow, Trubetskaya str., 8-2.
Natalya A. Nikitina, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology № 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov
First MSMU, Ministry of Health of Russia (Sechenov University). E-mail: natnikitina@list.ru. ORCID: 0000-0001-8659-9963. 119991, Russia, Moscow, Trubetskaya str., 8-2.
Ara L. Unanyan, Dr. Med. Sci., Professor, Professor of the Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University). Tel.: +7(903)960-35-26. E-mail: 9603526@mail.ru. ORCID: 0000-0002-2283-2356.
8-2 Trubetskaya str., Moscow, 119991, Russia.
Mikhail B. Ageev, Ph.D., Teaching Assistant at the Department of Obstetrics and Gynecology №1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University). E-mail: mikhaageev@yandex.ru. ORCID: 0000-0002-6603-804X. 119991, Russia, Moscow, Trubetskaya str., 8-2.
Albert A. Kokin, Head of the Department of Anesthesiology and Intensive Care, Maternity Hospital affiliated to the V.V. Veresaev Clinical Hospital of Moscow City Health Department. E-mail: Alberkokin@yandex.ru. ORCID: 0000-0001-7615-4530.
127247, Russia, Moscow, 800th anniversary of Moscow str., 22.

For citation: Sidorova I.S., Nikitina N.A., Unanyan A.L., Ageev M.B., Kokin A.A. The complement system during physiological pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 6: 14-20 (in Russian)
https://dx.doi.org/10.18565/aig.2021.6.14-20

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