title: Relationship of Circulating C5a and Complement Factor H Levels With Disease Control in Pregnant Women With Asthma.
abstract: BACKGROUND
  Asthma often complicates pregnancy and represents a risk of serious pregnancy complications. The complement system contributes to asthma pathogenesis and is up-regulated in healthy gestation as well. The anaphylatoxin C5a has a major pro-inflammatory role, and the complement factor H is a main soluble regulator protein both in asthma and during pregnancy; however, peripheral levels of these complement factors and their relationship to disease control have not yet been evaluated in pregnant subjects with asthma.
  
  
  METHODS
  The present study aimed to investigate circulating C5a and complement factor H levels in asthma (non-pregnant subjects with asthma; n = 19) and in pregnancy with asthma (pregnant subjects with asthma; n = 22), compared with healthy non-pregnant (n = 21) and healthy pregnant women (n = 13) and to test their relationship to clinical parameters of asthma (lung function, airway inflammation, and symptoms).
  
  
  RESULTS
  Circulating C5a levels were higher in the pregnant asthma subject group compared with the healthy non-pregnant, healthy pregnant, and non-pregnant asthma groups: median 2.629 (interquartile range [IQR] 2.257-3.052) ng/mL versus 1.84 (IQR 1.576-2.563), 1.783 (IQR 0.6064-2.786), and 2.024 (IQR 1.232-2.615) ng/mL, respectively (P = .02 in all cases). C5a correlated negatively with FEV1 (r = -0.44, P = .039) and FVC values (r = -0.64, P = .001) in the pregnant asthma group and positively with fraction of exhaled nitric oxide levels in the non-pregnant asthma group (n = 12, r = 0.78, P = .004). Complement factor H levels were elevated in both the healthy pregnant and pregnant asthma subject groups compared with the healthy non-pregnant group (median 1,082 [IQR 734.9-1,224] and 910.7 [IQR 614.5-1076] μg/mL vs. 559.7 [IQR 388.7-783.1] μg/mL, P = .002 and P = .004, respectively) but not in the pregnant asthma group compared with the non-pregnant asthma group (median 687.4 [IQR 441.6-947.6] μg/mL, P = .10).
  
  
  CONCLUSIONS
  Asthma during pregnancy increases the circulating level of pro-inflammatory C5a, which is accompanied by impaired lung function and partly counteracted by the gestation-specific elevation of regulatory complement factor H level (detected in pregnancy both in healthy and subjects with asthma).
authors.affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: Anikó
authors.initials: A
authors.lastname: Bohács
authors.affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Bikov
authors.affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Ivancsó
authors.affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: Ibolya
authors.initials: I
authors.lastname: Czaller
authors.affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: Renáta
authors.initials: R
authors.lastname: Böcskei
authors.affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: Veronika
authors.initials: V
authors.lastname: Müller
authors.affiliation: 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Rigó
authors.affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Losonczy
authors.affiliation: Department of Pulmonology, Semmelweis University, Budapest, Hungary. tamasi.lilla@med.semmelweis-univ.hu.
authors.forename: Lilla
authors.initials: L
authors.lastname: Tamási
mesh_terms: D000328:Adult; D001249:Asthma / Q000097:blood* / Q000503:physiopathology; D016022:Case-Control Studies; D015936:Complement C5a / Q000378:metabolism*; D017242:Complement Factor H / Q000378:metabolism; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007249:Inflammation; D008168:Lung / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000503:physiopathology; D014797:Vital Capacity / Q000502:physiology
chemical_list: C493495:CFH protein, human; D015936:Complement C5a; D017242:Complement Factor H
keywords: C5a; asthma; biomarker; complement; complement factor H; pregnancy