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Hum. Reprod. Advance Access published online on November 11, 2006
Human Reproduction, doi:10.1093/humrep/del392
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received July 14, 2006
Revised August 25, 2006
Accepted September 14, 2006

Article

Mannose-binding lectin levels during pregnancy: a longitudinal study

F.E. van de Geijn 1 *, A. Roos 2, Y.A. de Man 1, J.D. Laman 1, C.J.M. de Groot 3, M.R. Daha 4, J.M.W. Hazes 1, and R.J.E.M. Dolhain 5

1 Department of Rheumatology, Immunology and Gynaecology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
2 Department of Clinical Chemistry, Leiden University Medical Center, Leiden, The Netherlands; Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
3 Department of Gynaecology, Medical Center Haaglanden, The Hague, The Netherlands
4 Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
5 Department of Rheumatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands

* To whom correspondence should be addressed.
F.E. van de Geijn, E-mail: f.vandegeijn{at}erasmusmc.nl


  Abstract

BACKGROUND: Pregnancy is associated with changes in the immune system. Although previous studies have focussed mainly on adaptive immunity, there are indications that components of innate immunity, such as mannose-binding lectin (MBL), are associated with pregnancy outcome. Although this would suggest that pregnancy also involves adaptations in innate immunity, there are few studies in this area. Therefore, we aimed to determine whether MBL concentrations and the following steps in complement pathway activation are influenced by pregnancy. METHODS: MBL and Ficolin-2 concentrations, MBL-MBL-associated serine protease (MASP) complex activity, MBL pathway activity and classical complement pathway activity were determined by enzyme-linked immunosorbent assay (ELISA) in sera from pregnant women (n = 32) during each trimester and post-partum. MBL genotyping was performed by PCR. RESULTS: During pregnancy, MBL concentrations increased to 140% [interquartile range (IQR) 116-181%, P < 0.0001]. This increase was already present at 12 weeks of pregnancy and was most pronounced in the high-production AA-genotype. Directly Post-partum MBL concentrations dropped to 57% of baseline (IQR 44-66%, P < 0.0001). Variations in MBL levels were reflected by similar changes in the following steps of complement activation, r > 0.93 (P < 0.01). Ficolin-2 levels and classical complement pathway activity were not similarly influenced by pregnancy. CONCLUSIONS: Pregnancy and the post-partum period profoundly influence MBL serum concentration and MBL complement pathway activity.

Keywords: innate immunity/mannose-binding lectin/pregnancy/polymorphisms/lectin complement pathway.
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