A starfish hemolymph factor which activates vertebrate complement in the presence of cobra venom factor.
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Biomedical subjects
Publications and source records attributed to R A Good.
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Both localized and generalized Shwartzman reactions were induced in the same rabbits by simultaneous administration of preparatory intravenous and intradermal doses of endotoxin followed in 24 hr by the provocative dose. Control rabbits with more than 80% positive responses showed corresponding changes of platelet, white blood cell, fibrinogen, and hemolytic complement levels. Circulating fibrinogen and fibrin degradation products were detected shortly after the preparatory dose and persisted for at least 3 days. Rabbits given cobra venom anticomplementary factor showed hypocomplementemia (less than 10% of normal), leukocytosis, and elevated fibrinogen levels. After the administration of endotoxin, only one of 15 CVF-treated animals developed a Shwartzman reaction and that was mild. These rabbits showed only minor changes of platelet and fibrinogen levels throughout the experiment although their white blood cell responses were similar to those of the control group. No detectable fibrinogen and fibrin degradation products appeared in circulation, and the hemolytic complement activity increased gradually beginning with the preparatory dose of endotoxin. Thus depletion of terminal complement components (mainly C3) in rabbits is protective against the development of both localized and generalized Shwartzman reactions; its mechanism of action is probably through the sparing of platelets by inhibiting platelet-endotoxin interaction. The essential role of the complement system in Shwartzman reaction indicates that this coagulopathy probably represents a manifestation of immunologic injury.
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In 11 patients receiving transplants of allogeneic bone marrow, the graft was successful in six. Nine patients developed infections, and six died-five of septicaemia and one of Pneumocystis carinii pneumonia. Fifty individual infections occurred. Predisposing factors included severe underlying diseases, long-term exposure to resistant hospital organisms, heavy immunosuppressive therapy, and graft-versus-host disease. Gram-negative bacilli and Candida albicans were the most common causative organisms. In every instance of septicaemia identical organisms were isolated from blood cultures and simultaneously obtained stool cultures. Infection with exogenous organisms often occurred in patients occupying conventional isolation rooms. Isolation of one patient for 45 days in a laminar air flow room prevented infection with exogenous organisms.
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