Proceedings: Activation of endotoxin-induced intravascular coagulation in congenitally C6-deificient rabbits.
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The interaction of d.l. activity with chicken red cells (CE) generates a cell intermediate with the properties of classical E*. Generation of CE* by d.l. activity at 37 degrees C is rapid, while there is a considerable lag in the conversion of CE* to ghost and hemoglobin. Conversion of CE* to ghosts can be blocked by high concentration of EDTA and/or 0 degrees C. CE* contain at least C6 and C9 on their surface.
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Human endothelial cells (EC), cultured serum-free, synthesize de novo protein which increasingly bind to agarose beads (an alternative pathway activator), until a plateau phase is reached after 24-48 h. EC synthesize functional C3, C5, C6, C8 and C9, which were detected on co-cultured agarose beads, using relevant polyclonal anti-complement antibodies. Two monoclonal anti-C9 neoepitope antibodies (aE11, poly C9-MA) bound to the co-cultured beads, showing that the terminal complement complex (TCC) (C5b-9) was assembled on the beads. This also suggests that C7 is synthesized. There seems to be a positive correlation between the amount of agarose-bound labelled protein and agarose-bound complement. The results indicate that EC produce and secrete the components for the functional alternative and terminal pathways of complement.
Three Japanese families with members carrying C7 silent allele(s) (C7*Q0) are presented. C6 types in the family members were also examined, and it was found that C7*Q0 was transmitted from a parent to offsprings as a haplotype, C7*Q0-C6*B. In another study of C6 types in sera from 3 volunteer blood donors with homozygous C7 deficiencies, the C6 phenotypes were found to be C6 B (homozygote). It seems remarkable that C7*Q0 can be associated with C6*B.
To evaluate the effect of membrane lipid acyl-chain packing on the efficiency of cell lysis by complement, we have studied membrane modulation by 2-(2-methoxy)-ethoxyethyl-8-(cis-2-n-octylcyclopropyl)-octanoate (A2C) and by myristoleyl alcohol, the cis isomer of a C14:1 aliphatic alcohol. These substances are known to increase the membrane lipid disorder by virtue of the bend in their acyl chains, which is believed to loosen the phospholipid acyl-chain packing. We have found that both of these compounds markedly enhance the lysis of erythrocytes by the terminal complement proteins C5b-9. The enhancing effect by A2C is operative in the formation of erythrocytes carrying complement components C5b, C6, and C7, as well as in the subsequent reactions with complement components C8 and C9. We have also found that A2C-treated erythrocytes bind C5b6 to a measurable extent, whereas untreated erythrocytes do not. We attribute this to a shift in the partition equilibrium of C5b6 toward membrane association, which would improve lytic efficiency. The increase of membrane lipid disorder by these agents would also be expected to increase insertion of hydrophobic peptides from C7, C8, and C9, with consequent gain in lytic efficiency. Treatment of erythrocytes with sublytic doses of NaDodSO4, or Triton X-100 did not enhance lysis by C5b-9 appreciably, suggesting that enhancement of lysis by C5b-9 is not a general property of amphiphiles.
The distribution of MspI restriction fragment length polymorphism (RFLP) alleles was investigated using the C6-PVX probe of the sixth component of complement (C6) and DNA from lymphocytes of 11 patients with homozygous C6 deficiency (C6Q0), 18 of their family members, 3 patients with subtotal C6 deficiency (C6SD) and 28 normal C6-sufficient controls. A biallelic polymorphism of 12.5- and 8.2-kb RFLP alleles was observed, and co-dominant inheritance of the two alleles was demonstrated in family studies. All 11 C6Q0 patients were homozygous for the 12.5-kb allele; this includes 8 unrelated propositi. The gene frequencies for both the 12.5- and 8.2-kb alleles in control subjects were 0.5, and the association of C6*Q0 with the 12.5-kb allele was found to be highly significant (p = 0.0001). Family studies in a C6Q0 family demonstrated that the MspI polymorphism may be used to trace C6*Q0 heterozygous carriers. Studies in families with C6SD, when considered with the results of C6 and C7 allotyping, showed definite co-segregation of C6*SD with the MspI 8.2-kb allele in one family and very probable co-segregation in another. All 11 South African C6Q0 subjects were homozygous for the C6Q0/MspI 12.5-kb/C7 M haplotype. Our data describe new associations of C6 deficiency genes which may assist in the future identification of the molecular defects.
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Three structural forms of C7 have been distinguished by isoelectric focusing. They are the products of three co-dominantly expressed alleles at an autosomal locus. The C7 locus is close to that for C6, but is not close to the HLA complex.
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Quantitative hemolytic assays for C6 and C7 using as R reagents sera from patients deficient in these components are described. The assays gave linear results. Normal range for serum C6 was found to be 21,400--41,700 C6 hemolytic units/ml; for serum C7 the normal range was 5540--9860 C7 hemolytic units/ml.
A serum factor, which inhibits haemolysis of the buffer control used in a C3 haemolytic assay, was found in a C3-deficient subject (C3D). Since the buffer control consisted of EAC142, C5 and C6-9 reagent (C6-9R, prepared by treatment of guinea-pig serum with KSCN and hydrazine hydrate), the factor seems to be an inhibitor of C3-independent immune haemolysis. Gel filtration and CM cellulose column chromatography of C3D serum suggested that the inhibitor may be C8. The inhibition was not observed in C8-depleted C3D serum. Furthermore, isolated C8 was found to inhibit haemolysis of EAC142 by C5 and C6-9R in a dose-dependent fashion. Thus, C8 was found to be an inhibitor of C3-independent immune haemolysis in the assay. Further studies revealed that C8 also inhibits haemolysis of EAC142 by C3, C5 and C6-9R (C3 assay system) or that of EAC1423 by C5 and C6-9R (C5 assay system), indicating that C3 or C5 haemolytic activity can be underestimated by the presence of C8 in a sample. C8 did not inhibit haemolysis in the assay system when isolated C6-C9 of human origin were used, but did inhibit haemolysis when isolated C6-C9 of guinea-pig origin was used instead of C6-9R. Thus, it was suggested that the incompatibility of human C8 with guinea-pig C6-C9 might be responsible for this phenomenon. Additional experiments for the mechanism clearly showed that human C8 inhibits the haemolysis of EAC1-7 (EA bearing human C1-C5 and guinea-pig C6 and C7) by guinea-pig C8 and C9 by binding to EAC1-7 prior to guinea-pig C8.
C6 typing was performed in a family material by two different techniques: serum or plasma samples were subjected either to high-voltage agarose gel electrophoresis or to isoelectric focusing in polyacrylamide gel slabs. Proteins with C6 activity were then visualized by a specific, hemolytic assay. In 81 unrelated adults within the family material the following allele frequencies were found: C6A:0.61 and C6B:0.39. Linkage studies exclude linkage between C6 and HLA region marker loci, and also between C6 and another chromosome 6 marker locus PGM3.
By routine screening of sera, a subject was discovered who showed a sub-total deficiency of C6 and C7. No clinical disease was associated with this deficiency which was transmitted through the subject's family as a single genetic characteristic, the C6 deficiency being associated with a silent allele at the structural locus. The propositus was found to have low quantities of an abnormal C6 which was both antigenically deficient and smaller in size than normal C6 (110,000 daltons compared with 140,000 daltons) and small quantities of apparently normal C7. It is concluded that the most likely explanation for this defect is that the subject has a structural mutation in his C6 gene which produces hyopsynthesis not only of C6 but also of the closely linked gene for C7. These findings suggest the possibility that C6 and C7 may function as a single genetic unit and that the primary transcript copied from the genome includes information for both proteins.
An 18-year-old black female (D.B.) in good general health was found to have no hemolytic activity in serum CH50 titrations. Functional assays yielded normal values for all C components except C6. C6 was not detectable in plasma or serum by two different functional assays nor by antigenic analysis using monospecific anti-C6 antibody. Hemolytic activity was restored by addition of functionally pure C6. By specific functional assay, both parents and 5 of 6 available sibs had approximately half-normal serum C6 levels and 1 sib was normal. Biologic properties of D.B. serum include: a) absent bactericidal activity against S. typhi 0 901 with or without added rabbit antibody; b) normal generation of chemotactic activity for human neutrophils in the presence of endotoxin or aggregated IgG; c) ability to sensitize appropriate cells for immune adherence of agglutination by anti-C3 Coombs serum; and d) inability to lyse PNH red cells in either acid hemolysis or "sugar water" tests. An extensive clotting workup by standard methods was within normal limits. These studies document for the first time a human kindred with C6 deficiency. This defect exhibits a classic mendelian autosomal inheritance, with all 3 genotypes being recognizable. Unlike the C6-deficient rabbits studied by others, the homozygous C6-deficient human exhibits chemotactic and coagulation functions within the range of normal.
Platelet aggregation and the selective release of 5-hydroxytryptamine (5HT) and adenine nucleotides were measured in platelet-rich plasma (PRP) and washed platelet suspensions from control and C6-deficient rabbits. Aggregation and release induced by collagen were similar in both groups of animals. Aggregation responses to zymosan in control PRP samples were biphasic, and only the second phase was associated with release. In C6-deficient PRP samples, zymosan-induced aggregation lacked the second phase and there was no release of 5HT or adenine nucleotides. Zymosan induced no aggregation in washed platelet suspensions unless cell-free plasma was also added. C6-deficient plasma supported only primary aggregation, but the addition of control plasma resulted in biphasic aggregation and release. Zymosan which had been pre-activated in control or C6-deficient cell-free plasma induced primary aggregation in washed platelet suspensions. To obtain secondary aggregation and release, the addition of control plasma to the platelet suspension was necessary.
A new reliable and reproducible technique for the simultaneous determination of C6 and C7 types is presented, which employs double replica electroblotting after isoelectric focusing. It permitted clear discrimination of both C6 and C7 components, and the patterns were nearly comparable to those demonstrated separately. The population data obtained by this new technique fitted the genetic hypothesis. The present double replica electroblotting method was successfully applied to the combined phenotyping of C6 and C7 from bloodstains which were stored at room temperature for up to 4 weeks. The method is quite suitable for medicolegal examination of bloodstains particularly for the saving in the amount of sample.
Using a physiologic model of hypersensitivity pneumonitis where depressions of arterial oxygen tension in unimmunized rabbits are monitored following aerosol challenge with Aspergillus terreus spores, attempts were made to assess the nature of the cellular and pharmacologic mediators of the impairment. Unlike normal animals no PaO2 depressions were obtained following aerosol challenge in either rabbits deficient in C6 or in rabbits made thrombocytopenic with antiplatelet serum. Such aerosols were also shown to produce platelet count depressions of up to 45% in normal rabbits. Finally, in vitro evidence of histamine release was obtained following incubation of Aspergillus extract, platelets and autologous serum from unimmunized rabbits. It was concluded that Aspergillus-induced pulmonary disease may be initiated by platelet release of mediators such as histamine stimulated by nonspecific complement activation.