Circulating immune complexes, C3b inactivator, C3 activator, C3c, C4 and C-reactive protein were assayed in 49 patients with pre-eclampsia and 35 apparently healthy pregnant Nigerian women. Pre-eclamptic women had significantly higher mean levels of circulating immune complexes, C3c and C-reactive protein. C3 activator mean level was also higher in pre-eclampsia than in normal pregnancy, C3b inactivator concentrations were greatly depressed and the mean level was also significantly lower in the pre-eclamptic group (P less than 0.001). However, C4 mean levels were the same in both groups. From the results, it is postulated that in pre-eclamptic conditions the significantly depressed levels of C3b inactivator could predispose to the persistence of deposited immune complexes in the kidneys, resulting in tissue damage. The findings also generally indicate an immunologic pathogenesis for the renal lesions in pre-eclampsia in Nigerian women.
The levels of malarial fluorescent antibody titers (MFAT) were estimated throughout pregnancy and at delivery in 20 urban Nigerian primigravidas who received malarial chemoprophylaxis. There was a statistically significant (p < 0.001) fall in the MFAT levels as pregnancy progressed. The mean logarithmic MFAT levels were 2.8664 +/- 0.3326 and 2.2794 +/- 0.1656 in the first and last trimesters of pregnancy, respectively. The MFAT level in the newborn was positively correlated to the maternal MFAT level at delivery (r = 0.9468; p < 0.001). If malarial prophylactics are used for a prolonged period, the maternal MFAT level will fall, leaving newborns with lowered immunity to malaria.
The effects of a substance or substances associated with malarial parasites on the inhibitory role of C3b inactivator in immune adherence were investigated. The test system involved adherence of immune complexes of complement-bearing sheep erythrocytes and rabbit antibody, using human group O erythrocytes and human renal glomerular tissues as indicators. Malarial antigen and other soluble by-products of the malarial parasites, presumably present in spent culture medium, did not interfere with the inhibitory role of C3b inactivator. However, malarial pigment, both crude and purified, enhanced immune adherence in the presence of C3b inactivator. It is suggested that malarial pigment, by inhibiting the action of C3b inactivator, may play a significant role in the immunopathogenesis of renal lesions associated with malarial infections.
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