akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2026.692akusherstvo-2668Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫImmune system dysregulation in preeclampsia: a contemporary viewpoint on the role of regulatory T cells and complement activationДисрегуляция иммунной системы при преэклампсии: современный взгляд на роль регуляторных Т-клеток и активацию системы комплементаhttps://orcid.org/0009-0002-0177-9207СтепанянН. С.StepanyanN. S.

Степанян Наринэ Сергеевна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Narine S. Stepanyan 

29 Nahichevansky Lane, Rostov-on-Don 344022

mff5475485@gmail.comhttps://orcid.org/0009-0005-6982-0271КоржЮ. В.KorzhYu. V.

Корж Юлия Витальевна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Yulia V. Korzh, MD

29 Nahichevansky Lane, Rostov-on-Don 344022 

https://orcid.org/0009-0005-0601-6534ИванисоваН. Г.IvanisovaN. G.

Иванисова Наталья Григорьевна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Natalia G. Ivanisova 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0007-2180-8999РамазановА. Г.RamazanovA. G.

Рамазанов Абдулла Гаджиевич 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Abdulla G. Ramazanov 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0002-4509-8577ПарагянИ. А.ParagyanI. A.

Парагян Ирина Ашотовна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Irina A. Paragyan 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0002-2207-496XЭминоваК. Ш.EminovaK. Sh.

Эминова Карина Шамильевна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Karina Sh. Eminova 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0006-3819-6346РустамханЛ. А.RustamkhanL. A.

Рустамхан Лема Аминулло 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Lema A. Rustamkhan, MD 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0001-5345-8299ЯхияеваЭ. Э.YakhiyaevaE. E.

Яхияева Эльвина Эрвиновна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Elvina E. Yakhiyaeva 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0004-4871-4907МирзаЭ. М. Р.MirzaE. M.R.

Мирза Эльвира Мохаммад Ризаевна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Elvira M.R. Mirza 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0005-8435-7182ЕршоваС. С.ErshovaS. S.

Ершова София Сергеевна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Sofiya S. Ershova 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0007-0428-3748КаракаевА. Д.KarakaevA. D.

Каракаев Амин Дахирович 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Amin D. Karakaev 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0000-4034-4818РомановаН. М.RomanovaN. M.

Романова Натела Максимовна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Natela M. Romanova 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0001-9625-0164ДолгиеваЛ. М.DolgievaL. M.

Долгиева Лема Магометовна 

344022 Ростов-на-Дону, Нахичеванский переулок, д. 29

Lema M. Dolgieva 

29 Nahichevansky Lane, Rostov-on-Don 344022

https://orcid.org/0009-0007-7155-5555КононенкоВ. А.KononenkoV. A.

Кононенко Вероника Алексеевна 

344000 Ростов-на-Дону, Пушкинская ул., д. 127

Veronika A. Kononenko, MD 

127 Pushkinskaya Str., Rostov-on-Don, 344000

ФГБОУ ВО «Ростовский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияRostov State Medical University, Ministry of Health of the Russian FederationRussian FederationГАУ Ростовской области «Областной консультативно-диагностический центр»РоссияRegional Consultative and Diagnostic CenterRussian Federation202610052026202363379Copyright © Stepanyan N.S., Korzh Y.V., Ivanisova N.G., Ramazanov A.G., Paragyan I.A., Eminova K.S., Rustamkhan L.A., Yakhiyaeva E.E., Mirza E.M., Ershova S.S., Karakaev A.D., Romanova N.M., Dolgieva L.M., Kononenko V.A., 20262026Степанян Н.С., Корж Ю.В., Иванисова Н.Г., Рамазанов А.Г., Парагян И.А., Эминова К.Ш., Рустамхан Л.А., Яхияева Э.Э., Мирза Э.М., Ершова С.С., Каракаев А.Д., Романова Н.М., Долгиева Л.М., Кононенко В.А.Stepanyan N.S., Korzh Y.V., Ivanisova N.G., Ramazanov A.G., Paragyan I.A., Eminova K.S., Rustamkhan L.A., Yakhiyaeva E.E., Mirza E.M., Ershova S.S., Karakaev A.D., Romanova N.M., Dolgieva L.M., Kononenko V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/2668

Preeclampsia (PE) is a pregnancy complication characterized by arterial hypertension, proteinuria, and multi-organ dysfunction. This review is dedicated to analyzing data on the role of immune system dysregulation in PE pathogenesis, by focusing on two key components: impaired regulatory T cells (Treg) function and hyperactivation of the complement system. Under normal conditions, pregnancy involves the establishment of immune tolerance to the semi-allogeneic fetus, a central element of which is presented by a pool of paternal antigen-specific Tregs. In PE, a Treg quantitative and functional deficiency is observed, leading to an imbalance and a shift towards the proliferation of pro-inflammatory Th17 cells (T-helper 17 cells), which in turn causes systemic inflammation. Concurrently, there is an excessive activation of the complement system, evidenced by elevated anaphylatoxins level (C3a, C5a) and the formation of the membrane attack complex (C5b-9) in the blood and placental tissue. These components damage the trophoblast and endothelium, exacerbating placental dysfunction. A critical insight is the existence of a bidirectional crosstalk between these systems. The activation of anaphylatoxin receptors of complement components C3a and C5a (anaphylatoxin receptors C3a, C5a, C3aR/C5aR) destabilizes Tregs and interferes with their suppressive function, while the Treg deficiency, in turn, weakens the control over complement activation processes, partly due to reduced production of anti-inflammatory cytokines – interleukin-10 (IL-10), transforming growth factor-beta (TGF-β). This self-perpetuating cycle of immune dysregulation underlies the impairment of placentation, systemic endothelial dysfunction, and PE clinical manifestation. Understanding these interconnected mechanisms opens prospects for developing novel targeted strategies aimed at restoring the Treg balance and suppressing pathological complement activity to prevent PE.

Преэклампсия (ПЭ) – это осложнение беременности, характеризующееся артериальной гипертензией, протеинурией и полиорганной дисфункцией. Настоящий обзор посвящен анализу данных о роли дисрегуляции иммунной системы в патогенезе ПЭ, с акцентом на двух ключевых компонентах: нарушении функции регуляторных Т-клеток (англ. regulatory T cells, Treg) и гиперактивации системы комплемента. В норме беременность сопровождается формированием иммунной толерантности к полуаллогенному плоду, центральным элементом которой является пул специфичных к отцовским антигенам Treg. При ПЭ наблюдается количественный и функциональный дефицит Treg, что приводит к нарушению их баланса и пролиферации в сторону провоспалительных Th17-клеток (англ. T-helper 17 cells; Т-хелперы 17-го типа), что приводит к системному воспалению. Параллельно с этим происходит чрезмерная активация системы комплемента, о чем свидетельствует повышение уровней анафилатоксинов (C3a, C5a) и формированием мембраноатакующего комплекса (C5b-9) в крови и плацентарной ткани. Эти компоненты повреждают трофобласт и эндотелий, усугубляя плацентарную дисфункцию. Ключевым моментом является наличие двунаправленного взаимодействия между данными системами. Активация рецепторов анафилатоксинов компонентов комплемента C3a и C5a (англ. anaphylatoxin receptors C3a, C5a, C3aR/C5aR) дестабилизирует Treg и подавляет их супрессорную функцию, а дефицит Treg, в свою очередь, ослабляет контроль над процессами активации комплемента, в том числе из-за снижения выработки противовоспалительных цитокинов – интерлейкина (англ. interleukin, IL) IL-10, трансформирующего фактора роста-бета (англ. transforming growth factor-beta, TGF-β). Формирующийся порочный круг патогенеза иммунной дисрегуляции ложится в основу нарушения процессов плацентации, системной эндотелиальной дисфункции и клинической манифестации ПЭ. Понимание этих взаимосвязанных механизмов открывает перспективы для разработки новых таргетных стратегий, направленных на восстановление баланса Treg и подавление патологической активности комплемента с целью профилактики ПЭ

преэклампсияПЭиммунная дисрегуляциябеременностьрегуляторные T-клеткиTregсистема комплементаиммунология беременностиактивация комплементаиммунная толерантностьплацентацияиммунный гомеостазpreeclampsiaPEimmune dysregulationpregnancyregulatory T cellsTregcomplement systempregnancy immunologycomplement activationimmune toleranceplacentationimmune homeostasisReferencesСидорова И.С., Унанян А.Л., Никитина Н.А. и др. Сравнительная оценка молекулярных и иммуногистохимических маркеров иммунного повреждения эндотелия сосудов у беременных с артериальной гипертензией и преэклампсией. Акушерство, Гинекология и Репродукция. 2012;6(4):29–32.Sidorova I.S., Unanayan A.L., Nikitina N.A. et al. Comparative assessment of molecular and immunohistochemical markers of immune vascular endothelial damage in pregnants with hypertension and preeclampsia. [Sravnitel'naya ocenka molekulyarnyh i immunogistohimicheskih markerov immunnogo povrezhdeniya endoteliya sosudov u beremennyh s arterial'noj gipertenziej i preeklampsiej]. Obstetrics, Gynecology and Reproduction. 2012;6(4):29–32. (In Russ.).Шахбазова Н.А. Клинико-иммунологические особенности течения беременности при гипертензивных состояниях, вызванных беременностью. Акушерство, Гинекология и Репродукция. 2014;8(3):11–7.Shakhbazova N.A. Clinical and immunological course of gestation during pregnancy induced hypertension. [Kliniko-immunologicheskie osobennosti techeniya beremennosti pri gipertenzivnyh sostoyaniyah, vyzvannyh beremennost'yu]. Obstetrics, Gynecology and Reproduction. 2014;8(3):11–7. (In Russ.).Сюндюкова Е.Г., Чулков В.С., Рябикина М.Г. Преэклампсия: современное состояние проблемы. Доктор.Ру. 2021;20(1):11–6. https://doi.org/10.31550/1727-2378-2021-20-1-11-16.Syundyukova E.G., Chulkov V.S., Ryabikina M.G. Preeclampsia: current state of the problem. [Preeklampsiya: sovremennoe sostoyanie problem]. Doctor.Ru. 2021;20(1):11–6. (In Russ.). https://doi.org/10.31550/1727-2378-2021-20-1-11-16.Керкешко Г.О., Кореневский А.В., Соколов Д.И. и др. Роль взаимодействия экстраклеточных микровезикул трофобласта с клетками иммунной системы и эндотелия в патогенезе преэклампсии. Медицинская иммунология. 2018;20(4):485–514. https://doi.org/10.15789/1563-0625-2018-4-485-514.Kerkeshko G.O., Korenevskiy A.V., Sokolov D.I. et al. The role of the interaction between trophoblast extracellular microvesicles with immune system and endothelial cells in the pathogenesis of preeclampsia. [Rol' vzaimodeistviya ekstrakletochnykh mikrovezikul trofoblasta s kletkami immunnoy sistemy i endoteliya v patogeneze preeklampsii]. Meditsinskaya immunologiya. 2018;20(4):485–514. (In Russ.). https://doi.org/10.15789/1563-0625-2018-4-485-514.Saito S., Nakashima A., Shima T., Tsuda S. Pregnancy depends on a delicate balance of immune activation and regulation. Explor Immunol. 2021;1:461–78. https://doi.org/10.37349/ei.2021.00031.Saito S., Nakashima A., Shima T., Tsuda S. Pregnancy depends on a delicate balance of immune activation and regulation. Explor Immunol. 2021;1:461–78. https://doi.org/10.37349/ei.2021.00031.Стрижаков А.Н., Тимохина Е.В., Ибрагимова С.М. и др. Новые возможности дифференциального прогнозирования ранней и поздней преэклампсии. Акушерство, Гинекология и Репродукция. 2018;12(2):55–61. https://doi.org/10.17749/2313-7347.2018.12.2.055-061.Strizhakov A.N., Timokhina Е.V., Ibragimova S.M. et al. A novel approach to the differential prognosis of early and late preeclampsia. [Novye vozmozhnosti differencial'nogo prognozirovaniya rannej i pozdnej preeklampsii]. Obstetrics, Gynecology and Reproduction. 2018;12(2):55– 61. (In Russ.). https://doi.org/10.17749/2313-7347.2018.12.2.055-061.Tsuda S., Nakashima A., Shima T., Saito S. New paradigm in the role of regulatory T cells during pregnancy. Front Immunol. 2019;10:573. https://doi.org/10.3389/fimmu.2019.00573.Tsuda S., Nakashima A., Shima T., Saito S. New paradigm in the role of regulatory T cells during pregnancy. Front Immunol. 2019;10:573. https://doi.org/10.3389/fimmu.2019.00573.Jørgensen N., Persson G., Hviid T.V.F. The tolerogenic function of regulatory T cells in pregnancy and cancer. Front Immunol. 2019;10:911. https://doi.org/10.3389/fimmu.2019.00911.Jørgensen N., Persson G., Hviid T.V.F. The tolerogenic function of regulatory T cells in pregnancy and cancer. Front Immunol. 2019;10:911. https://doi.org/10.3389/fimmu.2019.00911.Piccinni M.P., Raghupathy R., Saito S., Szekeres-Bartho J. Cytokines, hormones and cellular regulatory mechanisms favoring successful reproduction. Front Immunol. 2021;12:717808. https://doi.org/10.3389/fimmu.2021.717808.Piccinni M.P., Raghupathy R., Saito S., Szekeres-Bartho J. Cytokines, hormones and cellular regulatory mechanisms favoring successful reproduction. Front Immunol. 2021;12:717808. https://doi.org/10.3389/fimmu.2021.717808.Son M. Understanding the contextual functions of C1q and LAIR-1 and their applications. Exp Mol Med. 2022;54:567–72. https://doi.org/10.1038/s12276-022-00774-4.Son M. Understanding the contextual functions of C1q and LAIR-1 and their applications. Exp Mol Med. 2022;54:567–72. https://doi.org/10.1038/s12276-022-00774-4.Morita K., Tsuda S., Kobayashi E. et al. Analysis of TCR repertoire and PD-1 expression in decidual and peripheral CD8+ T cells reveals distinct immune mechanisms in miscarriage and preeclampsia. Front Immunol. 2020;11:1082. https://doi.org/10.3389/fimmu.2020.01082.Morita K., Tsuda S., Kobayashi E. et al. Analysis of TCR repertoire and PD-1 expression in decidual and peripheral CD8+ T cells reveals distinct immune mechanisms in miscarriage and preeclampsia. Front Immunol. 2020;11:1082. https://doi.org/10.3389/fimmu.2020.01082.Robillard P.Y., Dekker G., Scioscia M., Saito S. Progress in the understanding of the pathophysiology of immunologic maladaptation related to early-onset preeclampsia and metabolic syndrome related to late-onset preeclampsia. Am J Obstet Gynecol. 2022;226(2S):S867– S875. https://doi.org/10.1016/j.ajog.2021.11.019.Robillard P.Y., Dekker G., Scioscia M., Saito S. Progress in the understanding of the pathophysiology of immunologic maladaptation related to early-onset preeclampsia and metabolic syndrome related to late-onset preeclampsia. Am J Obstet Gynecol. 2022;226(2S):S867–S875. https://doi.org/10.1016/j.ajog.2021.11.019.Антонова А.С., Хизроева Д.Х., Калашникова И.С. и др. Система комплемента у беременных с тяжелой преэклампсией. Акушерство, Гинекология и Репродукция. 2025;19(3):443–52. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2025.626.Antonova A.S., Khizroeva J.Kh., Kalashnikova I.S. et al. The complement system in pregnant women with severe preeclampsia. [Sistema komplementa u beremennyh s tyazheloj preeklampsiej]. Obstetrics, Gynecology and Reproduction. 2025;19(3):443–52. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2025.626.Bicocca M.J., Mendez-Figueroa H., Chauhan S.P., Sibai B.M. Maternal obesity and the risk of early-onset and late-onset hypertensive disorders of pregnancy. Obstet Gynecol. 2020;136(1):118–27. https://doi.org/10.1097/aog.0000000000003901.Bicocca M.J., Mendez-Figueroa H., Chauhan S.P., Sibai B.M. Maternal obesity and the risk of early-onset and late-onset hypertensive disorders of pregnancy. Obstet Gynecol. 2020;136(1):118–27. https://doi.org/10.1097/aog.0000000000003901.Green S., Politis M., Rallis K.S. et al. Regulatory T cells in pregnancy adverse outcomes: a systematic review and meta-analysis. Front Immunol. 2021;12:737862. https://doi.org/10.3389/fimmu.2021.737862.Green S., Politis M., Rallis K.S. et al. Regulatory T cells in pregnancy adverse outcomes: a systematic review and meta-analysis. Front Immunol. 2021;12:737862. https://doi.org/10.3389/fimmu.2021.737862.Zhang Y., Liu Z., Tian M. et al. The altered PD-1/PD-L1 pathway delivers the 'one-two punch' effects to promote the Treg/Th17 imbalance in pre-eclampsia. Cell Mol Immunol. 2018;15(7):710–23. https://doi.org/10.1038/cmi.2017.70.Zhang Y., Liu Z., Tian M. et al. The altered PD-1/PD-L1 pathway delivers the 'one-two punch' effects to promote the Treg/Th17 imbalance in pre-eclampsia. Cell Mol Immunol. 2018;15(7):710–23. https://doi.org/10.1038/cmi.2017.70.Schwarze J.E., Borda P., Vásquez P. et al. Is the risk of preeclampsia higher in donor oocyte pregnancies? A systematic review and metaanalysis. JBRA Assist Reprod. 2018;22(1):15–9. https://doi.org/10.5935/1518-0557.20180001.Schwarze J.E., Borda P., Vásquez P. et al. Is the risk of preeclampsia higher in donor oocyte pregnancies? A systematic review and metaanalysis. JBRA Assist Reprod. 2018;22(1):15–9. https://doi.org/10.5935/1518-0557.20180001.Pohjonen E.M., Söderström-Anttila V., Bergh C. et al. Obstetric and perinatal risks after the use of donor sperm: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2022;274:210–28. https://doi.org/10.1016/j.ejogrb.2022.05.031.Pohjonen E.M., Söderström-Anttila V., Bergh C. et al. Obstetric and perinatal risks after the use of donor sperm: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2022;274:210–28. https://doi.org/10.1016/j.ejogrb.2022.05.031.Антонова А.С., Хизроева Д.Х., Бицадзе В.О. и др. Генетическая тромбофилия и антифосфолипидные антитела у женщин с ранней и поздней преэклампсией: ретроспективное когортное исследование. Акушерство, Гинекология и Репродукция. 2025;19(1):14–25. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.586.Antonova A.S., Khizroeva J.Kh., Bitsadze V.O. et al. Genetic thrombophilia and antiphospholipid antibodies in women with early and late preeclampsia: a retrospective cohort study. [Geneticheskaya trombofiliya i antifosfolipidnye antitela u zhenshchin s rannej i pozdnej preeklampsiej: retrospektivnoe kogortnoe issledovanie]. Obstetrics, Gynecology and Reproduction. 2025;19(1):14–25. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.586.Пицхелаури Е.Г., Стрижаков А.Н., Богачева Н.А. и др. Раннее прогнозирование преэклампсии у беременных после вспомогательных репродуктивных технологий. Акушерство, Гинекология и Репродукция. 2019;13(4):305–12. https://doi.org/10.17749/2313-7347.2019.13.4.305-312.Pitskhelauri E.G., Strizhakov A.N., Bogacheva N.A. et al. Early predicting of preeclampsia in pregnant women after assisted reproductive technologies. [Rannee prognozirovanie preeklampsii u beremennyh posle vspomogatel'nyh reproduktivnyh tekhnologij]. Obstetrics, Gynecology and Reproduction. 2019;13(4):305–12. (In Russ.). https://doi.org/10.17749/2313-7347.2019.13.4.305-312.Robillard P.Y., Dekker G., Scioscia M. et al. Increased BMI has a linear association with late-onset preeclampsia: A population-based study. PLoS One. 2019;14(10):e0223888. https://doi.org/10.1371/journal.pone.0223888.Robillard P.Y., Dekker G., Scioscia M. et al. Increased BMI has a linear association with late-onset preeclampsia: A population-based study. PLoS One. 2019;14(10):e0223888. https://doi.org/10.1371/journal.pone.0223888.Moldenhauer L.M., Schjenken J.E., Hope C.M. et al. Thymus-derived regulatory T cells exhibit Foxp3 epigenetic modification and phenotype attenuation after mating in mice. J Immunol. 2019;203(3):647–57. https://doi.org/10.4049/jimmunol.1900084.Moldenhauer L.M., Schjenken J.E., Hope C.M. et al. Thymus-derived regulatory T cells exhibit Foxp3 epigenetic modification and phenotype attenuation after mating in mice. J Immunol. 2019;203(3):647–57. https://doi.org/10.4049/jimmunol.1900084.Ahn S.H., Nguyen S.L., Petroff M.G. Exploring the origin and antigenic specificity of maternal regulatory T cells in pregnancy. Front Immunol. 2020;11:1302. https://doi.org/10.3389/fimmu.2020.01302.Ahn S.H., Nguyen S.L., Petroff M.G. Exploring the origin and antigenic specificity of maternal regulatory T cells in pregnancy. Front Immunol. 2020;11:1302. https://doi.org/10.3389/fimmu.2020.01302.Warren B.D., Ahn S.H., McGinnis L.K. et al. Autoimmune regulator is required in female mice for optimal embryonic development and implantation. Biol Reprod. 2019;100(6):1492–504. https://doi.org/10.1093/biolre/ioz023.Warren B.D., Ahn S.H., McGinnis L.K. et al. Autoimmune regulator is required in female mice for optimal embryonic development and implantation. Biol Reprod. 2019;100(6):1492–504. https://doi.org/10.1093/biolre/ioz023.Salvany-Celades M., van der Zwan A., Benner M. et al. Three types of functional regulatory T cells control T cell responses at the human maternal-fetal interface. Cell Rep. 2019;27(9):2537–47.e5. https://doi.org/10.1016/j.celrep.2019.04.109.Salvany-Celades M., van der Zwan A., Benner M. et al. Three types of functional regulatory T cells control T cell responses at the human maternal-fetal interface. Cell Rep. 2019;27(9):2537–47.e5. https://doi.org/10.1016/j.celrep.2019.04.109.Bending D., Ono M. From stability to dynamics: understanding molecular mechanisms of regulatory T cells through Foxp3 transcriptional dynamics. Clin Exp Immunol. 2019;197(1):14–23. https://doi.org/10.1111/cei.13194.Bending D., Ono M. From stability to dynamics: understanding molecular mechanisms of regulatory T cells through Foxp3 transcriptional dynamics. Clin Exp Immunol. 2019;197(1):14–23. https://doi.org/10.1111/cei.13194.Joudi A.M., Reyes Flores C.P., Singer B.D. Epigenetic control of regulatory T cell stability and function: implications for translation. Front Immunol. 2022;13:861607. https://doi.org/10.3389/fimmu.2022.861607.Joudi A.M., Reyes Flores C.P., Singer B.D. Epigenetic control of regulatory T cell stability and function: implications for translation. Front Immunol. 2022;13:861607. https://doi.org/10.3389/fimmu.2022.861607.Джегутанов А.А., Шерышева К.А., Муталипов А.Р. и др. Маточные естественные киллеры и исходы беременности: механизмы, биомаркеры и терапевтические мишени. Акушерство, Гинекология и Репродукция. 2025;[принятая рукопись]. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2025.674.Dzhegutanov A.A., Sherysheva K.A., Mutalipov A.R. et al. Uterine natural killer cells and pregnancy outcomes: mechanisms, biomarkers, and therapeutic targets. [Matochnye estestvennye killery i iskhody beremennosti: mekhanizmy, biomarkery i terapevticheskie misheni]. Obstetrics, Gynecology and Reproduction. 2025;[accepted manuscript]. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2025.674.Li J., Huang L., Wang S., Zhang Z. The prevalence of regulatory T and dendritic cells is altered in peripheral blood of women with pre-eclampsia. Pregnancy Hypertens. 2019;17:233–40. https://doi.org/10.1016/j.preghy.2019.07.003.Li J., Huang L., Wang S., Zhang Z. The prevalence of regulatory T and dendritic cells is altered in peripheral blood of women with pre-eclampsia. Pregnancy Hypertens. 2019;17:233–40. https://doi.org/10.1016/j.preghy.2019.07.003.Tsuda S., Zhang X., Hamana H. et al. Clonally expanded decidual effector regulatory T cells increase in late gestation of normal pregnancy, but not in preeclampsia, in humans. Front Immunol. 2018;9:1934. https://doi.org/10.3389/fimmu.2018.01934.Tsuda S., Zhang X., Hamana H. et al. Clonally expanded decidual effector regulatory T cells increase in late gestation of normal pregnancy, but not in preeclampsia, in humans. Front Immunol. 2018;9:1934. https://doi.org/10.3389/fimmu.2018.01934.Пашковский Д.Г., Соловьева Е.В., Рабаданова Ц.Р. и др. Профиль экспрессии плазматических микроРНК и генов-мишеней у пациенток с осложненным течением беременности. Акушерство, Гинекология и Репродукция. 2023;17(2):231–43. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.413.Pashkovsky D.G., Solovieva E.V., Rabadanova Ts.R. et al. Expression profile of plasma microRNAs and target genes in patients with complicated pregnancy. [Profil' ekspressii plazmaticheskih mikroRNK i genov-mishenej u pacientok s oslozhnennym techeniem beremennosti]. Obstetrics, Gynecology and Reproduction. 2023;17(2):231–43. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.413.Geldenhuys J., Rossouw T.M., Lombaard H.A. et al. Disruption in the regulation of immune responses in the placental subtype of preeclampsia. Front Immunol. 2018;9:1659. https://doi.org/10.3389/fimmu.2018.01659.Geldenhuys J., Rossouw T.M., Lombaard H.A. et al. Disruption in the regulation of immune responses in the placental subtype of preeclampsia. Front Immunol. 2018;9:1659. https://doi.org/10.3389/fimmu.2018.01659.Lu H.Q., Hu R. The role of immunity in the pathogenesis and development of preeclampsia. Scand J Immunol. 2019;90(5):e12756. https://doi.org/10.1111/sji.12756.Lu H.Q., Hu R. The role of immunity in the pathogenesis and development of preeclampsia. Scand J Immunol. 2019;90(5):e12756. https://doi.org/10.1111/sji.12756.Qu H., Yu Q., Jia B. et al. HIF-3α affects preeclampsia development by regulating EVT growth via activation of the Flt-1/JAK/STAT signaling pathway in hypoxia. Mol Med Rep. 2021;23(1):68. https://doi.org/10.3892/mmr.2020.11701.Qu H., Yu Q., Jia B. et al. HIF-3α affects preeclampsia development by regulating EVT growth via activation of the Flt-1/JAK/STAT signaling pathway in hypoxia. Mol Med Rep. 2021;23(1):68. https://doi.org/10.3892/mmr.2020.11701.Chen J., Zhao L., Wang D. et al. Contribution of regulatory T cells to immune tolerance and association of microRNA-210 and Foxp3 in preeclampsia. Mol Med Rep. 2019;19(2):1150–8. https://doi.org/10.3892/mmr.2018.9733.Chen J., Zhao L., Wang D. et al. Contribution of regulatory T cells to immune tolerance and association of microRNA-210 and Foxp3 in preeclampsia. Mol Med Rep. 2019;19(2):1150–8. https://doi.org/10.3892/mmr.2018.9733.Mora-Palazuelos C., Villegas-Mercado C.E., Avendaño-Félix M. et al. The role of ncRNAs in the immune dysregulation of preeclampsia. Int J Mol Sci. 2023;24(20):15215. https://doi.org/10.3390/ijms242015215.Mora-Palazuelos C., Villegas-Mercado C.E., Avendaño-Félix M. et al. The role of ncRNAs in the immune dysregulation of preeclampsia. Int J Mol Sci. 2023;24(20):15215. https://doi.org/10.3390/ijms242015215.Saito S., Tsuda S., Nakashima A. T cell immunity and the etiology and pathogenesis of preeclampsia. J Reprod Immunol. 2023;159:104125. https://doi.org/10.1016/j.jri.2023.104125.Saito S., Tsuda S., Nakashima A. T cell immunity and the etiology and pathogenesis of preeclampsia. J Reprod Immunol. 2023;159:104125. https://doi.org/10.1016/j.jri.2023.104125.Котельникова В.Э.А., Пантюхова Д.Е., Аблямитова Ф.Д. и др. Особенности транскрипционного профиля пациенток с ранней и поздней преэклампсией. Акушерство, Гинекология и Репродукция. 2024;18(2):167– 79. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.483.Kotelnikova V.E.A., Pantyukhova D.E., Ablyamitova F.D. et al. Transcriptional profile features in patients with early and late preeclampsia. [Osobennosti transkripcionnogo profilya pacientok s rannej i pozdnej preeklampsiej]. Obstetrics, Gynecology and Reproduction. 2024;18(2):167–79. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.483.Пашковский Д.Г., Соловьева Е.В., Рабаданова Ц.Р. и др. Профиль экспрессии плазматических микроРНК и генов-мишеней у пациенток с осложненным течением беременности. Акушерство, Гинекология и Репродукция. 2023;17(2):231–43. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.413.Pashkovsky D.G., Solovieva E.V., Rabadanova Ts.R. et al. Expression profile of plasma microRNAs and target genes in patients with complicated pregnancy. [Profil' ekspressii plazmaticheskih mikroRNK i genov-mishenej u pacientok s oslozhnennym techeniem beremennosti]. Obstetrics, Gynecology and Reproduction. 2023;17(2):231–43. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.413.Murray E.J., Gumusoglu S.B., Santillan D.A., Santillan M.K. Manipulating CD4+ T cell pathways to prevent preeclampsia. Front Bioeng Biotechnol. 2022;9:811417. https://doi.org/10.3389/fbioe.2021.811417.Murray E.J., Gumusoglu S.B., Santillan D.A., Santillan M.K. Manipulating CD4+ T cell pathways to prevent preeclampsia. Front Bioeng Biotechnol. 2022;9:811417. https://doi.org/10.3389/fbioe.2021.811417.Robertson S.A., Green E.S., Care A.S. et al. Therapeutic potential of regulatory T cells in preeclampsia – opportunities and challenges. Front Immunol. 2019;10:478. https://doi.org/10.3389/fimmu.2019.00478.Robertson S.A., Green E.S., Care A.S. et al. Therapeutic potential of regulatory T cells in preeclampsia – opportunities and challenges. Front Immunol. 2019;10:478. https://doi.org/10.3389/fimmu.2019.00478.Meggyes M., Miko E., Lajko A. et al. Involvement of the PD-1/PD-L1 co-inhibitory pathway in the pathogenesis of the inflammatory stage of early-onset preeclampsia. Int J Mol Sci. 2019;20(3):583. https://doi.org/10.3390/ijms20030583.Meggyes M., Miko E., Lajko A. et al. Involvement of the PD-1/PD-L1 co-inhibitory pathway in the pathogenesis of the inflammatory stage of early-onset preeclampsia. Int J Mol Sci. 2019;20(3):583. https://doi.org/10.3390/ijms20030583.Хонина Н.А., Пасман Н.М., Черных Е.Р. Ингибиторные молекулы как регуляторы иммунной толерантности при беременности. Иммунология. 2023;44(4):491–9. https://doi.org/10.33029/0206-4952-2023-44-4-491-499.Khonina N.A., Pasman N.M., Chernykh E.R. Inhibitory molecules as regulators of immune tolerance during pregnancy. [Inhibitornye molekuly kak regulytatory immunnoj tolerantnosti pri beremennosti]. Immunologiya. 2023;44(4):491–9. (In Russ.). https://doi.org/10.33029/0206-4952-2023-44-4-491-499.Headen K., Jakaite V., Mesaric V.A. et al. The role of regulatory T cells and their therapeutic potential in hypertensive disease of pregnancy: A literature review. Int J Mol Sci. 2024;25(9):4884. https://doi.org/10.3390/ijms25094884.Headen K., Jakaite V., Mesaric V.A. et al. The role of regulatory T cells and their therapeutic potential in hypertensive disease of pregnancy: A literature review. Int J Mol Sci. 2024;25(9):4884. https://doi.org/10.3390/ijms25094884.Юсупова З.С., Новикова В.А., Оленев А.С. Современные представления о преэклампсии – патогенез, диагностика, прогнозирование. Практическая медицина. 2018;16(6):45–51. https://doi.org/10.32000/2072-1757-2018-16-6-45-51.Yusupova Z.S., Novikova V.A., Olenev A.S. Modern concepts of preeclampsia – pathogenesis, diagnosis, prediction. [Sovremennye predstavleniya o preeklampsii – patogenez, diagnostika, prognozirovanie]. Prakticheskaya meditsina. 2018;16(6):45–51. (In Russ.). https://doi.org/10.32000/2072-1757-2018-16-6-45-51.Care A.S., Bourque S.L., Morton J.S. et al. Reduction in regulatory T cells in early pregnancy causes uterine artery dysfunction in mice. Hypertension. 2018;72(1):177–87. https://doi.org/10.1161/hypertensionaha.118.10858.Care A.S., Bourque S.L., Morton J.S. et al. Reduction in regulatory T cells in early pregnancy causes uterine artery dysfunction in mice. Hypertension. 2018;72(1):177–87. https://doi.org/10.1161/hypertensionaha.118.10858.Balduit A., Agostinis C., Mangogna A. et al. Systematic review of the complement components as potential biomarkers of pre-eclampsia: pitfalls and opportunities. Front Immunol. 2024;15:1419540. https://doi.org/10.3389/fimmu.2024.1419540.Balduit A., Agostinis C., Mangogna A. et al. Systematic review of the complement components as potential biomarkers of pre-eclampsia: pitfalls and opportunities. Front Immunol. 2024;15:1419540. https://doi.org/10.3389/fimmu.2024.1419540.Blakey H., Sun R., Xie L. et al. Pre-eclampsia is associated with complement pathway activation in the maternal and fetal circulation, and placental tissue. Pregnancy Hypertens. 2023;32:43–9. https://doi.org/10.1016/j.preghy.2023.04.001.Blakey H., Sun R., Xie L. et al. Pre-eclampsia is associated with complement pathway activation in the maternal and fetal circulation, and placental tissue. Pregnancy Hypertens. 2023;32:43–9. https://doi.org/10.1016/j.preghy.2023.04.001.Yonekura Collier A.-R., Zsengeller Z., Pernicone E. et al. Placental sFLT1 is associated with complement activation and syncytiotrophoblast damage in preeclampsia. Hypertens Pregnancy. 2019;38(3):193–9. https://doi.org/10.1080/10641955.2019.1640725.Yonekura Collier A.-R., Zsengeller Z., Pernicone E. et al. Placental sFLT1 is associated with complement activation and syncytiotrophoblast damage in preeclampsia. Hypertens Pregnancy. 2019;38(3):193–9. https://doi.org/10.1080/10641955.2019.1640725.Ma Y., Kong L.R., Ge Q. et al. Complement 5a-mediated trophoblasts dysfunction is involved in the development of pre-eclampsia. J Cell Mol Med. 2018;22(2):1034–1046. https://doi.org/10.1111/jcmm.13466.Ma Y., Kong L.R., Ge Q. et al. Complement 5a-mediated trophoblasts dysfunction is involved in the development of pre-eclampsia. J Cell Mol Med. 2018;22(2):1034–1046. https://doi.org/10.1111/jcmm.13466.Еремеева Д.Р., Зайнулина М.С. Оценка эффективности профилактики плацента-ассоциированных осложнений у пациенток с отягощенным акушерским анамнезом и циркуляцией антифосфолипидных антител. Акушерство, Гинекология и Репродукция. 2024;18(4):475–91. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.479.Eremeeva D.R., Zainulina M.S. Assessing the effectiveness of preventing placenta-associated complications in patients with burdened obstetric history and circulating antiphospholipid antibodies. [Ocenka effektivnosti profilaktiki placenta-associirovannyh oslozhnenij u pacientok s otyagoshchennym akusherskim anamnezom i cirkulyaciej antifosfolipidnyh antitel]. Obstetrics, Gynecology and Reproduction. 2024;18(4):475–91. (In Russ.). https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.479.Lokki A.I., Triebwasser M., Daly E. et al. Understanding rare genetic variants within the terminal pathway of complement system in preeclampsia. Genes Immun. 2025;26(1):22–6. https://doi.org/10.1038/s41435-024-00310-6.Lokki A.I., Triebwasser M., Daly E. et al. Understanding rare genetic variants within the terminal pathway of complement system in preeclampsia. Genes Immun. 2025;26(1):22–6. https://doi.org/10.1038/s41435-024-00310-6.Lokki A.I., Ren Z., Triebwasser M. et al. Identification of complement factor H variants that predispose to pre-eclampsia: A genetic and functional study. BJOG. 2023;130(12):1473–82. https://doi.org/10.1111/1471-0528.17529.Lokki A.I., Ren Z., Triebwasser M. et al. Identification of complement factor H variants that predispose to pre-eclampsia: A genetic and functional study. BJOG. 2023;130(12):1473–82. https://doi.org/10.1111/1471-0528.17529.Lokki A.I., Teirilä L., Triebwasser M. et al. Dysfunction of complement receptors CR3 (CD11b/18) and CR4 (CD11c/18) in pre-eclampsia: a genetic and functional study. BJOG. 2021;128(8):1282–91. https://doi.org/10.1111/1471-0528.16660.Lokki A.I., Teirilä L., Triebwasser M. et al. Dysfunction of complement receptors CR3 (CD11b/18) and CR4 (CD11c/18) in pre-eclampsia: a genetic and functional study. BJOG. 2021;128(8):1282–91. https://doi.org/10.1111/1471-0528.16660.Matsuyama T., Tomimatsu T., Mimura K. et al. Complement activation by an angiogenic imbalance leads to systemic vascular endothelial dysfunction: A new proposal for the pathophysiology of preeclampsia. J Reprod Immunol. 2021;145:103322. https://doi.org/10.1016/j.jri.2021.103322.Matsuyama T., Tomimatsu T., Mimura K. et al. Complement activation by an angiogenic imbalance leads to systemic vascular endothelial dysfunction: A new proposal for the pathophysiology of preeclampsia. J Reprod Immunol. 2021;145:103322. https://doi.org/10.1016/j.jri.2021.103322.Dijkstra D.J., Lokki A.I., Gierman L.M. et al. Circulating levels of anti-C1q and anti-factor H autoantibodies and their targets in normal pregnancy and preeclampsia. Front Immunol. 2022;13:842451. https://doi.org/10.3389/fimmu.2022.842451.Dijkstra D.J., Lokki A.I., Gierman L.M. et al. Circulating levels of anti-C1q and anti-factor H autoantibodies and their targets in normal pregnancy and preeclampsia. Front Immunol. 2022;13:842451. https://doi.org/10.3389/fimmu.2022.842451.Yasmin H., Agostinis C., Toffoli M. et al. Protective role of complement factor H against the development of preeclampsia. Front Immunol. 2024;15:1351898. https://doi.org/10.3389/fimmu.2024.1351898.Yasmin H., Agostinis C., Toffoli M. et al. Protective role of complement factor H against the development of preeclampsia. Front Immunol. 2024;15:1351898. https://doi.org/10.3389/fimmu.2024.1351898.Mathis K.W. Complementing T regulatory cells to combat hypertension. Circ Res. 2018;122(7):911–2. https://doi.org/10.1161/circresaha.118.312860.Mathis K.W. Complementing T regulatory cells to combat hypertension. Circ Res. 2018;122(7):911–2. https://doi.org/10.1161/circresaha.118.312860.Abdeladhim M., Karnell J.L., Rieder S.A. In or out of control: modulating regulatory T cell homeostasis and function with immune checkpoint pathways. Front Immunol. 2022;13:1033705. https://doi.org/10.3389/fimmu.2022.1033705.Abdeladhim M., Karnell J.L., Rieder S.A. In or out of control: modulating regulatory T cell homeostasis and function with immune checkpoint pathways. Front Immunol. 2022;13:1033705. https://doi.org/10.3389/fimmu.2022.1033705.Schanzenbacher J., Köhl J., Karsten C.M. Anaphylatoxins spark the flame in early autoimmunity. Front Immunol. 2022;13:958392. https://doi.org/10.3389/fimmu.2022.958392.Schanzenbacher J., Köhl J., Karsten C.M. Anaphylatoxins spark the flame in early autoimmunity. Front Immunol. 2022;13:958392. https://doi.org/10.3389/fimmu.2022.958392.West E.E., Kolev M., Kemper C. Complement and the regulation of T cell responses. Annu Rev Immunol. 2018;36(1):309–38. https://doi.org/10.1146/annurev-immunol-042617-053245.West E.E., Kolev M., Kemper C. Complement and the regulation of T cell responses. Annu Rev Immunol. 2018;36(1):309–38. https://doi.org/10.1146/annurev-immunol-042617-053245.Killick J., Morisse G., Sieger D. et al. Complement as a regulator of adaptive immunity. Semin Immunopathol. 2018;40:37–48. https://doi.org/10.1007/s00281-017-0644-y.Killick J., Morisse G., Sieger D. et al. Complement as a regulator of adaptive immunity. Semin Immunopathol. 2018;40:37–48. https://doi.org/10.1007/s00281-017-0644-y.Ancuța E., Zamfir R., Martinescu G. et al. The complement system, T cell response, and cytokine shift in normotensive versus pre-eclamptic and lupus pregnancy. J Clin Med. 2021;10(24):5722. https://doi.org/10.3390/jcm10245722.Ancuța E., Zamfir R., Martinescu G. et al. The complement system, T cell response, and cytokine shift in normotensive versus pre-eclamptic and lupus pregnancy. J Clin Med. 2021;10(24):5722. https://doi.org/10.3390/jcm10245722.Meister S., Hahn L., Beyer S. et al. Regulatory T cell apoptosis during preeclampsia may be prevented by Gal-2. Int J Mol Sci. 2022;23(3):1880. https://doi.org/10.3390/ijms23031880.Meister S., Hahn L., Beyer S. et al. Regulatory T cell apoptosis during preeclampsia may be prevented by Gal-2. Int J Mol Sci. 2022;23(3):1880. https://doi.org/10.3390/ijms23031880.Chen X.H., Ruan C.C., Ge Q. et al. Deficiency of complement C3a and C5a receptors prevents angiotensin II-induced hypertension via regulatory T cells. Circ Res. 2018;122(7):970–83. https://doi.org/10.1161/circresaha.117.312153.Chen X.H., Ruan C.C., Ge Q. et al. Deficiency of complement C3a and C5a receptors prevents angiotensin II-induced hypertension via regulatory T cells. Circ Res. 2018;122(7):970–83. https://doi.org/10.1161/circresaha.117.312153.Froehlich F., Landerholm K., Neeb J. et al. Emerging role of C5aR2: novel insights into the regulation of uterine immune cells during pregnancy. Front Immunol. 2024;15:1411315. https://doi.org/10.3389/fimmu.2024.1411315.Froehlich F., Landerholm K., Neeb J. et al. Emerging role of C5aR2: novel insights into the regulation of uterine immune cells during pregnancy. Front Immunol. 2024;15:1411315. https://doi.org/10.3389/fimmu.2024.1411315.Cross A.R., Lion J., Poussin K. et al. Inflammation determines the capacity of allogenic endothelial cells to regulate human treg expansion. Front Immunol. 2021;12:666531. https://doi.org/10.3389/fimmu.2021.666531.Cross A.R., Lion J., Poussin K. et al. Inflammation determines the capacity of allogenic endothelial cells to regulate human treg expansion. Front Immunol. 2021;12:666531. https://doi.org/10.3389/fimmu.2021.666531.Zhang Y., Wang H., Qiu P. et al. Decidual macrophages derived NO downregulates PD-L1 in trophoblasts leading to decreased Treg cells in recurrent miscarriage. Front Immunol. 2023;14:1180154. https://doi.org/10.3389/fimmu.2023.1180154.Zhang Y., Wang H., Qiu P. et al. Decidual macrophages derived NO downregulates PD-L1 in trophoblasts leading to decreased Treg cells in recurrent miscarriage. Front Immunol. 2023;14:1180154. https://doi.org/10.3389/fimmu.2023.1180154.Gadwa J., Bickett T.E., Darragh L.B. et al. Complement C3a and C5a receptor blockade modulates regulatory T cell conversion in head and neck cancer. J Immunother Cancer. 2021;9(3):e002585. https://doi.org/10.1136/jitc-2021-002585.Gadwa J., Bickett T.E., Darragh L.B. et al. Complement C3a and C5a receptor blockade modulates regulatory T cell conversion in head and neck cancer. J Immunother Cancer. 2021;9(3):e002585. https://doi.org/10.1136/jitc-2021-002585.Ding H., Zhang L., Yang W. et al. Decoding neutrophil extracellular traps and key gene drivers in unexplained pregnancy loss. Front Immunol. 2025;16:1628337. https://doi.org/10.3389/fimmu.2025.1628337.Ding H., Zhang L., Yang W. et al. Decoding neutrophil extracellular traps and key gene drivers in unexplained pregnancy loss. Front Immunol. 2025;16:1628337. https://doi.org/10.3389/fimmu.2025.1628337.Miller D., Motomura K., Galaz J. et al. Cellular immune responses in the pathophysiology of preeclampsia. J Leukoc Biol. 2022;111(1):237–60. https://doi.org/10.1002/jlb.5ru1120-787rr.Miller D., Motomura K., Galaz J. et al. Cellular immune responses in the pathophysiology of preeclampsia. J Leukoc Biol. 2022;111(1):237–60. https://doi.org/10.1002/jlb.5ru1120-787rr.Liu Y., Zhang Y., Du L., Chen D. The genetic relationships between immune cell traits, circulating inflammatory proteins and preeclampsia/ eclampsia. Front Immunol. 2024;15:1389843. https://doi.org/10.3389/fimmu.2024.1389843.Liu Y., Zhang Y., Du L., Chen D. The genetic relationships between immune cell traits, circulating inflammatory proteins and preeclampsia/ eclampsia. Front Immunol. 2024;15:1389843. https://doi.org/10.3389/fimmu.2024.1389843.Khan M.A., Alanazi F., Ahmed H.A. et al. C5a blockade increases regulatory T cell numbers and protects against microvascular loss and epithelial damage in mouse airway allografts. Front Immunol. 2018;9:1010. https://doi.org/10.3389/fimmu.2018.01010.Khan M.A., Alanazi F., Ahmed H.A. et al. C5a blockade increases regulatory T cell numbers and protects against microvascular loss and epithelial damage in mouse airway allografts. Front Immunol. 2018;9:1010. https://doi.org/10.3389/fimmu.2018.01010.Li S., Zhu J., Zhao Y. et al. Metabolic disorder of nutrients—an emerging field in the pathogenesis of preeclampsia. Front Nutr. 2025;12:1560610. https://doi.org/10.3389/fnut.2025.1560610.Li S., Zhu J., Zhao Y. et al. Metabolic disorder of nutrients – an emerging field in the pathogenesis of preeclampsia. Front Nutr. 2025;12:1560610. https://doi.org/10.3389/fnut.2025.1560610.Pierik E., Prins J.R., van Goor H. et al. Dysregulation of complement activation and placental dysfunction: a potential target to treat preeclampsia? Front Immunol. 2020;10:3098. https://doi.org/10.3389/fimmu.2019.03098.Pierik E., Prins J.R., van Goor H. et al. Dysregulation of complement activation and placental dysfunction: a potential target to treat preeclampsia? Front Immunol. 2020;10:3098. https://doi.org/10.3389/fimmu.2019.03098.

The authors declare that there are no conflicts of interest present.