THE ROLE OF COMPLEMENT IN PREGNANCY-INDUCED HYPERTENSIVE DISEASE

Preeclampsia is a pregnancy-induced hypertensive disease with an incid ence of about 5% in primigravidas and, being common, it significantly contributes to maternal and neonatal morbidity and mortality. The prim ary cause remains unknown but might be immunologic, since immunologic aberrations are described in preeclampsia. Activation of the complemen t system in pregnancy-induced hypertensive disease has been discussed during the last 60 years. It is now strongly indicated that complement activation occurs in preeclampsia. The complement system is very pote nt and one of the major effector pathways of the process of inflammati on. The pathological manifestations, endothelial damage and microvascu lar injury, and thereby the clinical findings in preeclampsia, may be explained by complement activation, resulting in the direct vascular e ffects of biological active complement components and complement-media ted activation of leukocytes, with release of potent inflammatory medi ators. This new etiological hypothesis might give other options in the rapy and prevention of pregnancy-induced hypertensive disease.