PT - JOURNAL ARTICLE AU - Anikó Bohács AU - András Bikov AU - István Ivancsó AU - Ibolya Czaller AU - Renáta Böcskei AU - Veronika Müller AU - János Rigó, Jr AU - György Losonczy AU - Lilla Tamási TI - Relationship of Circulating C5a and Complement Factor H Levels With Disease Control in Pregnant Women With Asthma AID - 10.4187/respcare.04339 DP - 2016 Apr 01 TA - Respiratory Care PG - 502--509 VI - 61 IP - 4 4099 - http://rc.rcjournal.com/content/61/4/502.short 4100 - http://rc.rcjournal.com/content/61/4/502.full AB - 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).