Supervisors info:
Γαβριηλάκη Ελένη, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΑΠΘ
Γρουζή Ελισάβετ, Αιματολόγος, Συντονίστρια Διευθύντρια ΝΥ Αιμοδοσίας, Γ.Α.Ο.Ν.Α. «Ο ΑΓΙΟΣ ΣΑΒΒΑΣ»
Κοκόρη Στυλιανή, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Over 100 years ago, Jules Bordet identified the complement system for its capacity to safeguard the host and lyse bacteria. Since then, the multifaceted activities of this potent enzymatic cascade have expanded beyond host defense and immunopathology, elucidating a role for the complement system in maintaining homeostasis and normal development. Initially, perceived as merely a humoral component of the immune system, the functions of complement have transcended its role as an extracellular system exclusively involved in bacterial lysis.
In the subsequent sections, a detailed analysis for the contribution of complement system in coordinating a typical pregnancy will be conducted, highlighting evidence that underscores the significance of regulating the system to prevent maternal pathology and the rejection of the semi-allogeneic fetus. Moreover, maintaining control over the complement system proves crucial for ensuring normal placental and fetal development, thereby averting lifelong adverse consequences for the offspring resulting from such pregnancies. The discussion will encompass an overview of the complement system and a comprehensive assessment of existing literature, revealing the involvement of complement in various events such as pre-implantation, implantation, placental development, and the overall progression from fetal development to parturition and labor. Examining studies showcasing dysregulation of the complement system in conditions like recurrent pregnancy loss, preterm birth, preeclampsia, hypertensive disorders of pregnancy, and intrauterine growth restriction will be a key focus. Ultimately, an exploration of potential therapeutic targets in diseases implicating complement pathophysiology will ensue, assessing the safety of their utilization during pregnancy. Furthermore, prospective research avenues will be deliberated concerning the use of inhibitors targeting all complement pathways throughout the duration of pregnancy and labor.
Keywords:
Complement, Pregnancy, Clinical practice, Complementopathies, Complement inhibitors