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[Concentrations of acute phase proteins in serum during the first two hours of hemodialysis using cuprophane and cellulose acetate dialyzers in patients with chronic renal failure].

In ten patients with chronic renal failure (CRF) serum concentrations of alpha 1-acid glycoprotein, alpha 1-antitrypsin, prealbumin, hemopexin, transferrin, haptoglobin, C3c and C4 complement components, ceruloplasmin, alpha 2-macroglobulin were determined using Partigen plates before, 30 min. and 2 hours after beginning of HD. Serum concentrations of C3c complement component, prealbumin increased significantly during HD using CU dialyser, but changes during HD using CA dialyser were not significant. Serum concentrations of alpha 1-antitrypsin, hemopexin increased significantly after two hours of HD using CA dialyser, but changes during HD using CU dialyser were again not significant. Serum concentrations of alpha 1-acid glycoprotein, transferrin, haptoglobin, ceruloplasmin, C4 complement component during HD using both dialyzers did not change significantly. Serum concentration of alpha 2-macroglobulin was higher after two hours of HD. The type of dialysis membrane has important influence on changes of serum acute phase proteins during the initial period of HD.

Acute-Phase Proteins↗

Changes of serum complement concentrations in tumour patients prior and after radiotherapy.

Peripheral blood concentrations of leucocytes, platelets and complement factors Clq, C3c, C3d, C4 and C5 were examined in 30 patients suffering from malignant tumours prior and after radiotherapy. In general, a decrease of blood cell concentrations as well as serum complement levels was noted using regression analysis. Two groups were formed: patients with (group I) and without (group II) foregoing tumour surgery. A positive correlation was found for all complement factors prior therapy in group I, whereas only some complement components did correlate in group II. The results in group I are in agreement with complements classical pathway activation. We conclude that the alternative pathways influence is responsible for the different results in group II.

Combined Modality Therapy↗

C3 cleavage products stimulate release of prostaglandins by human mononuclear phagocytes in vitro.

Human monocytes cultured for up to 48 hr in serum-free, chemically defined culture media released low levels of prostaglandin. C3b, C3bi, and C3c stimulated an indomethacin-sensitive, dose-responsive increase in the amount of monocyte prostaglandin released by 18 hr after treatment. Native C3 and C3d, which do not bind to monocyte receptors, failed to stimulate increased prostaglandin release. Lymphocytes, treated and untreated, produced 10(-2) to 10(-3) as much prostaglandin as the monocytes. These data support the concept that monocytes are a significant source of leukocyte prostaglandin. They also introduce an important new biologic function for the C3 fragments C3b, C3bi, and C3c.

Cells, Cultured↗

Immunopathology of subcutaneous rheumatoid nodules.

Nodules obtained from five patients with classical seropositive rheumatoid arthritis were studied by an immunofluorescence technique using polyclonal antibodies to IgG, IgA, IgM, C3c, and fibrin, and monoclonal antibodies to the terminal (C5b-9) complement complex (reaction with a neoantigen in C9 revealed during activation), DR antigens, T cells, macrophages, and interdigitating cells. In all instances the central necrotic areas stained strongly for fibrin and more weakly for IgG, IgA, IgM, C3, and terminal complement complex. The surrounding palisading cells reacted with antibodies to DR and macrophages. In the peripheral granulomatous tissue most of the lymphocytes reacted with the antibodies to T cells, whereas various amounts of the larger mononuclear cells were stained by antibodies to DR antigens, macrophages, and interdigitating cells. In all instances the walls of some of the smaller vessels in the granulomatous tissue stained for fibrin, C3, and terminal complement complex. Plasma cells were not seen except for scattered IgM cells in one nodule. These results support the view that the palisading cells are derived from macrophages, and indicate that there is vasculitis with activation of C3 and the terminal complement pathway in the granulomatous tissue.

Arthritis, Rheumatoid↗

In situ characterization of the inflammatory cell infiltrates of hyperplastic denture stomatitis.

Cryostat sections from 14 surgical specimens were examined to determine whether selected factors of the immune response related to histopathological reactions are present in the palatal mucosa affected by hyperplastic denture stomatitis. By means of various immunological techniques the presence of IgG, IgA, IgM, complement factor C3c, receptors for the Fc region of IgG (FcR) and for complement factor C3b (C3bR), T lymphocytes, and macrophages were studied. The inflammatory infiltrate was mainly located in the papillary part of the lamina propria. IgG, IgA, and IgM appeared both in plasma cells and intercellularly. FcR, C3bR, and T lymphocytes were present in the areas with inflammatory cell infiltrate. Macrophages were found in the papillary part of the lamina propria and within the epithelium. The immunological response in the mucosa affected by denture stomatitis was in many respects similar to that of marginal and apical periodontitis. We conclude that hyperplastic denture stomatitis is a complex inflammatory lesion showing elements of both humoral and cellular immune responses.

Antibody Formation↗

[Clinicopathological study of Henoch-Schönlein purpura nephritis with special reference to C3c deposits].

The aim of this study was to evaluate glomerular C3c deposits of Henoch-Schönlein purpura nephritis (HSPN) in children. Fifty-one patients aged 7-15 years (20 males and 31 females) were studied. On histological investigation, crescent formation seen under light microscopy and subepithelial electron dense deposits (EDD) under electron microscopy were found to be related to the degree of proteinuria and the duration of proteinuria and/or hematuria. A comparative clinicopathological study was performed on C3c-positive patients (n = 22) and C3c-negative patients (n = 25). Histological findings, such as crescent formation and subepithelial EDD, had no relation to glomerular C3c-deposits. At renal biopsy, C3c deposits were positive in 65 % of patients with heavy proteinuria ( > 100mg/kg/day), and in 30% of mild proteinuria patients ( < 50mg/kg/day). The difference between the two groups was statistically significant (p < 0.05). The duration of proteinuria and/or hematuria in C3c-positive patients had a tendency to persist in comparison with that in C3c-negative cases. Renal biopsies on many cases of C3c-negarive patients were performed following the lapse of three months, while the biopsies on patients showing global (+) C3c deposits (n = 15) were conducted within the three-month period. These results suggest that glomerular C3c deposits influence the clinical conditions of patients with HSPN, and complement activation is generated in the early stage of HSPN.

Adolescent↗

Binding capacity of sera from systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) to C3c. Evaluation by enzyme linked immunosorbent assay (ELISA).

Immunoconglutinins (IKs) are autoantibodies directed against antigenic determinants on C3 complement component. An ELISA was performed to detect IKs in sera from 50 RA patients, 50 SLE patients and 50 normal subjects. Comparison showed significantly higher levels in patients than in normal subjects (p less than 0.001) and higher IKs levels in RA than in SLE (p less than 0.001). IKs were not related to others biological tests, except a statistically significant inverse correlation between IKs and circulating immune complexes levels detected by conglutinin binding assay in RA.

Adult↗

Immunofluorescence study of pemphigus from north India.

Both serum studies by indirect immunofluorescence (IIF) tests and skin biopsy examination by direct immunofluorescence (DIF) were performed on 22 cases of pemphigus with clinically active lesions. Twenty cases had pemphigus vulgaris and two, pemphigus foliaceus. The majority of cases (70%) were between 21 and 60 years old; the mean age was 39.5 +/- 12.7 years. There was no sex predilection. DIF showed the positive fluorescence of intercellular cement substance (ICS) of the epidermis in all 22 cases (100%). IgG was positive in 77.2%, followed sequentially by C3C (50%), IgA (45.45%), and IgM (36.36%). Six cases (27.27%) also showed granular immunoglobulin and/or complement deposits at the dermoepidermal junction. IIF detected serum antiepithelial antibodies in 18 cases (81.81%) using human esophagus as substrate. Most of these cases (88.88%) showed IgG type of antibodies; the other 11.11% exhibited IgA and IgM in low concentrations. 1+ titer positivity was observed in 15 cases. This study demonstrates the value of DIF for a definitive diagnosis of pemphigus. However, it is also important to appreciate that immunofluorescence is not a substitute for histopathology, but rather complementary to it.

Adult↗

Sequential evaluation of immunoreactivity in patients with melanoma undergoing surgery and adjuvant therapy.

The immunologic profile of 15 patients undergoing surgery and adjuvant chemoimmunotherapy for cutaneous melanoma was studied for a mean period of 18 months. In vivo cellular immunity was assayed by evaluation of delayed hypersensitivity response (DHR) to primary antigen and a panel of recall antigens. In vitro cellular immunity was evaluated to means of total and T-lymphocyte counts in peripheral blood and by the lymphocyte blastogenic response to phytohemagglutinin stimulation. Humoral immunity was assayed by determining the serum levels of IgG, IgA and IgM and of complement components C3c, C4 and Factor B. Phagocytic activity was studied by testing leukocyte chemotaxis, neutrophil phagocytosis and leukocyte random migration. The in vitro parameters were determined preoperatively at diagnosis, 6 times during the first 2 postoperative weeks, and then every month during adjuvant therapy. No correlation was found between DHR and clinico-pathologic stage of tumor, or with subsequent clinical course. Significant depression of total lymphocyte and T-lymphocyte count and blastogenic response of lymphocytes was found at diagnosis. The lymphocyte response to PHA decreased significantly in the early postoperative period but returned to preoperative levels one week after surgery. Periodic fluctuations of lymphocyte blastogenic response and progressive decrease of total lymphocyte counts and T-lymphocyte counts were observed during the 18-month follow-up. No significant alterations of immunoglobulin levels were recorded at diagnosis or during the postoperative period. Complement levels were within normal values preoperatively; in the early postoperative period a transient increase of C3c, C4 and Factor B was recorded, then complement levels progressively decreased. Parameters of phagocytic activity were normal at diagnosis and fluctuated within the normal range throughout the whole period of study.

Adult↗

Binding of fluid-phase complement components C3 and C3b to human lymphocytes.

It is known that a population of B-lymphocytes has receptors for the third component of complement, C3, and that these lymphocytes may be identified by their ability to form rosettes with sheep erythrocytes coated with covalently bound fragments of complement component C3. Human tonsil lymphocytes, enriched for B-cells, form rosettes with sheep erythrocytes coated with antibody and complement components C1, C4b and C3b (EAC143b cells). Fluid-phase C3 will inhibit rosette formation between EAC143b and human tonsil lymphocytes over the same concentration range as fluid-phase C3b. C3 is not cleaved to C3b during incubation with lymphocytes or with lymphocytes and EAC143b cells. Fluid-phase 125I-labelled C3 and 125I-labelled C3b bind to lymphocytes in a specific manner. The characteristics of binding of both radioiodinated C3 and radioiodinated C3b are very similar, but the binding oc C3 is again not a result of cleavage to C3b. Salicylhydroxamic acid does not inhibit binding of 125I-labelled C3 to tonsil lymphocytes at concentrations that completely inhibit binding of 125I-labelled C3 to EAC142 cells via the nascent binding site of C3b. It is concluded that C3 and C3b share a common feature involved in binding to lymphocytes bearing receptors for the third component of complement.

Animals↗

Pathogenetic factors in utricaria in children. A clinico-experimental study.

Results of a study in 62 patients with urticaria and 30 controls, all under 12 years of age, are reported. The study involved history taking and assays of immunoglobulins A, G, M, D, E, of complement fractions C3c and C4 and estimation of C1 estease inactivator activity in the plasma. Acute urticaria is more frequent than chronic urticaria in children, expecially in subjects with atopic diathesis; papular urticaria (or strophulus infantum) is particularly frequent in children under 6 years of age and in the male. Assays of plasma immunoglobulins demonstrated selective deficiency of IgA in two and significant reduction of this immunoglobulin in a further three cases. The mean levels of IgE proved normal in chronic urticaria, raised in acute urticaria, and very high in papular urticaria. Complement assays demonstrated, in one case, a reduction of C3c below 60 mg/100 ml, persisting after the disappearance of urticaria.

Acute Disease↗

C3c-binding in inflammatory rheumatic diseases.

Sera from 73 patients, 24 with rheumatoid arthritis (RA), 10 with Sjögren's syndrome (SS, 4 with and six without RA), 17 with Reiter's syndrome (RS), 10 with systemic lupus erythematosus (SLE), 9 with Yersinia arthritis (YA), and 3 with mixed connective tissue disease (MCTD) were examined by enzyme-immunoassay (EIA) for the presence of C3c-binding IgG, IgM, and IgA activity (C3cBIgG, C3cBIgM, C3cBIgA). This activity probably consists of immunoconglutinins and immunoglobulin aggregates. Significantly elevated C3cBIgG was found in the sera of patients with RA (p less than 0.01), SS, and SLE (p less than 0.02). C3cBIgM was elevated in SS and SLE (p less than 0.02). C3cBIgA was increased in RA (p less than 0.005), in SS and YA (p less than 0.02). Correlations of C3c-binding with erythrocyte sedimentation rate, hemoglobin, C-reactive protein, IgG-binding onto platelets, serum IgG, IgM, and IgA levels, and with rheumatoid factors of IgM and IgA classes were computed. C3cBIgG, C3cBIgM, and C3cBIgA correlated significantly with each other, but usually not with other laboratory variables. The exceptions were positive correlations of C3cBIgM with IgM-rheumatoid factors in RA (p less than 0.05), and with serum IgM levels in the whole series of patients (p less than 0.05). The use of C3c represents a new principle to detect abnormalities in the sera of patients with inflammatory rheumatic diseases. However, the pathogenic significance of elevated C3c-binding remains unknown.

Complement C3↗

Complement in acute and chronic arthritides: assessment of C3c, C9, and protectin (CD59) in synovial membrane.

OBJECTIVES: To investigate the role of complement cascade induced damage and protection against it in acute arthritides compared to rheumatoid arthritis and other chronic joint derangements. METHODS: C3c, C9, and protectin (CD59) were examined by avidin-biotin-peroxidase complex staining. RESULTS: Marked deposits of C3c and C9 were found in synovial vasculature and intercellular matrix of the lining in rheumatoid arthritis and in acute arthritides (including bacterial, reactive, and osteoarthritis flare up). Furthermore, protectin was not visible in synovial lining cells and was relatively weakly expressed in stromal and endothelial cells in rheumatoid arthritis; also in acute arthritides protectin expression was weak. In contrast, C3c and C9 deposits were not found in chronic conditions associated with degenerative diseases (osteoarthritis and osteochondritis dissecans) or mechanical causes (patellar luxation and a ruptured meniscus), in which also the protectin expression was prominent in synovial lining, endothelial and some stromal cells. CONCLUSIONS: Activation of the complement in rheumatoid arthritis and in acute arthritides seems to be associated with a decreased protection of synovial cells against cellular effects and lysis mediated by membrane attack complex.

Acute Disease↗

Characterization of receptors to the anaphylatoxins on isolated cells.

The anaphylatoxins exhibit three primary functions in vivo, i.e. they induce granulocyte sequestration and adherence, promote spasmogenesis or smooth muscle contraction and exert immunoregulatory influences. C5a receptors have been demonstrated on human neutrophils, human monocytes, rodent macrophages from both the lungs and peritoneal cavity, two mouse macrophage cell lines (RAW 264 and J774.A1) and guinea pig platelets. To date, only guinea pig platelet has been shown to possess C3a receptors. In depth studies with the rat mast cell have demonstrated that both direct and indirect activation mechanisms may be operative in the mast cell; however, neither mechanism appears to depend on receptor-mediated stimulation of these cells.

Anaphylatoxins↗

[Behavior of granulocytic receptors for Fc IgG fragment and C3 component of complement in patients with diabetes].

The count of peripheral neutrophils having the superficial receptors for Fc IgG fragment (FcR) and C3 component of the complement (CR) was determined in diabetic patients by using the rosette tests EA and EAC according to the modified Buescher method. A significantly lower percentage of neutrophils with FcR and CR receptors was found in patients with both insulin-dependent and noninsulin-dependent diabetes. The lowest values were found in noncompensated diabetes; in compensated diabetes they were higher but still significantly lower than in the controls. The difference was significant in both tests used. The results obtained suggest that the observed fall in the percentage of neutrophils with FcR and CR receptors is caused by metabolic disturbances associated with diabetes.

Complement C3c↗