title: Activation of CD35 and CD55 in HIV associated normal and pre-eclamptic pregnant women.
abstract: OBJECTIVE
  The delicate balance which exists between complement activation and its regulation is altered in HIV infection and pregnancy disorders such as pre-eclampsia. Therefore, the purpose of this study was to investigate the expression of complement regulatory (Creg) proteins (CD35 and CD55) in HIV associated normal and pre-eclamptic pregnancies.
  
  
  METHODS
  The total study population (n=100) consisted of normotensive pregnant (n=50) and pre-eclamptic (n=50) women. These groups were equally sub-stratified into HIV infected and uninfected groups (n=25 per group). Standard haematological tests were conducted. Flow cytometric analysis of isolated neutrophils were performed using fluorescein isothiocyanate-conjugated anti-CD35 and phycoerythrin-cyanine 5 conjugated anti-CD55.
  
  
  RESULTS
  HELLP syndrome characteristics of increased lactate dehydrogenase enzymes levels, low platelet counts, cell morphological abnormalities (red cell fragmentation) and anaemia were observed in 40% of the HIV infected pre-eclamptic group. Red cell fragmentation inclusive of burr cells and schistocytes were also noted. Activated partial thromboplastin time and fibrinogen differed significantly between the HIV uninfected pre-eclamptic compared to the HIV infected pre-eclamptic groups (p<0.01). Irrespective of HIV status, the mean fluorescence intensity of CD35 and CD55 were significantly higher in the pre-eclamptic compared to the normotensive pregnant (p=0.0001; p=0.0001 respectively) groups. In the pre-eclamptic groups, the expression of both CD35 and CD55 did not significantly differ between HIV infected and uninfected women (p=0.486; p=0.767 respectively).
  
  
  CONCLUSIONS
  This study demonstrates an up-regulation of complement regulatory proteins, CD35 and CD55 in HIV associated pre-eclamptic compared to normotensive pregnancy. This elevation of the Creg proteins is an adaptive immune response to the high complement-mediated cell lysis that occurs in HIV infection and further aggravated by the complement activated state of pre-eclampsia.
authors: Optics and Imaging Centre, University of KwaZulu-Natal, South Africa. Electronic address: razia.khan@nhls.ac.za.
authors: R
authors: R
authors: Khan
authors: Optics and Imaging Centre, University of KwaZulu-Natal, South Africa.
authors: K
authors: K
authors: Maduray
authors: Womens' Health and HIV Research Group, University of KwaZulu-Natal, South Africa.
authors: J
authors: J
authors: Moodley
authors: Optics and Imaging Centre, University of KwaZulu-Natal, South Africa. Electronic address: naickera@ukzn.ac.za.
authors: T
authors: T
authors: Naicker
mesh_terms: D000328:Adult; D018958:CD55 Antigens / Q000097:blood*; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000097:blood* / Q000150:complications; D006801:Humans; D009504:Neutrophils / Q000378:metabolism; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood*; D017463:Receptors, Complement 3b / Q000097:blood*; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D018958:CD55 Antigens; D017463:Receptors, Complement 3b
keywords: CD35; CD55; Complement system; HIV; Pre-eclampsia