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PubMed2005

Complementing the patient: a complement component deficiency in a patient with recurrent infections and glomerulonephritis.

We present a case showing the investigation of a 7-year-old girl with empyema and glomerulonephritis whose "immunological" defect was a single complement component (C2) deficiency which prevented her from activating her classical complement pathway. A defect in complement function should be suspected in any patient with severe or recurring pyogenic infections. Investigations of "? immune deficiency" should always include tests to assess the patency of the patient's complement system.

Child↗
PubMed1991

[Systemic lupus erythematosus associated with homozygous C2 deficiency. Apropos of a case report and literature review].

Inherited deficiencies of classical pathway complement components are rare and associated with autoimmune diseases and with increased susceptibility to bacterial infections. We report the clinical evolution and studies of the complement system in a 17-year-old female patient of Swiss origin presenting with systemic lupus erythematosus (malar rash, photosensitivity, leukopenia and antinuclear antibodies), in whom the hemolytically active second complement component (C2) was less than 10% of the normal value and antigenic C2 was not detectable. Linkage studies showed that the patient is HLA-A25, B18 positive and has the slow factor B allotype BfS. Further immunological assessment revealed low IgG4 concentrations in the patient, who had the G2M(23) allotype. The asymptomatic first degree family members had half-normal C2 levels compatible with a heterozygous state of C2 deficiency. Therapy with hydroxychloroquine for 17 months and topical sunscreen preparations produced marked clinical improvement. During the 4 years of follow-up, the patient has been well and shown only an abnormal titer of antinuclear antibodies. No infections were observed. To the best of our knowledge, 99 cases of homozygous C2 deficiency have been described so far and are discussed here.

Adolescent↗
PubMed1993

Synthesis and regulation of complement components by human monocytes/macrophages and by acute monocytic leukemia.

Proteins of the complement system (C2, C3) are synthesized by human monocytes and macrophages, thus providing an important local source of these proteins in vivo which serve as a first-line host defense mechanism. In this study, we investigated the production of complement components C2, C4, and C9 by human monocytes/macrophages and by the pathologic cells of acute monocytic leukemia which represent a source of immature monocytic precursors. Human blood monocytes were collected and purified by cytapheresis and elutriation and leukemic cells by Ficoll gradient. Secretion of complement components was measured by a hemolytic assay. The evaluation of the mRNAs of the various complement components in the cells was performed by polymerase chain reaction (PCR) by adding 32P labeled deoxycytidinetriphosphate (dCTP) to the amplification step. Functional C2 was found to increase during in vitro maturation of macrophages up to the fourth week of culture. C2 mRNA was detected after amplification and increased during the maturation. Interferon-gamma (IFN-gamma) mediated a marked increase of the C2 mRNA. We found a decrease in synthesis of C4 mRNA during in vitro differentiation of human monocytes. The effect of IFN-gamma resulted in an increase in C4 mRNA. C9 mRNA was not detected although it was detected in the HepG2 hepatoma-derived cell line. Functional C2 was not detected by leukemic cells after 24 h of culture but little functional C4 was present in the cell supernatants. As they were by human monocytes and macrophages, C2 and C4 mRNAs were detected after amplification but C9 mRNAs were not detected.(ABSTRACT TRUNCATED AT 250 WORDS)

Actins↗
PubMed1981

The location of C2, C4, and BF relative to HLA-B and HLA-D.

The loci for HLA-A,B,C,D, and DR are known to be closely linked to the structural loci for the complement components C2, BF, and the duplicated loci for C4, C4A and C4B. Conflicting evidence has been presented for the order of these genes. However, new techniques have made possible identification of markers in the HLA-D and C4 region for nearly all identified haplotypes. In our population we have confirmed five HLA-B-D crossovers and in each case informative allotypes of C2, BF, or C4A and C4B segregated with HLA-D or DR suggesting that the loci for these proteins lie close to HLA-D and DR. These findings may be of importance for resolving problems encountered in the assignment of HLA-D alleles.

Complement C2↗
PubMed1982

Gold inhibition of the production of the second complement component by lymphokine-stimulated human monocytes.

The ability of gold sodium thiomalate to inhibit production of the second complement component (C2) by monocytes stimulated by a lymphokine (monocyte complement stimulator is demonstrated. This gold salt inhibits C2 production irreversibly if monocytes are incubated with it before or during lymphokine stimulation. Thiomalic acid is not inhibitory. Monocytes already stimulated by lymphokine are resistant to inhibition of C2 production by gold sodium thiomalate. Gold salts do not reduce monocyte viability, phagocytic ability (latex heads) accessory cell function (as measured by the ability to present antigen to autologous lymphocytes), or capacity to act as stimulating cells in mixed leukocyte culture. Gold sodium thiomalate's inhibition of monocyte responsiveness to lymphokine may be significant in explaining the therapeutic benefit of gold salts in rheumatoid arthritis.

Cell Survival↗
PubMed1991

[Immunogenetic markers (BF, C2, C4, 21-OH, TNF alpha, TCR beta, Ig) and insulin-dependent diabetes in the Tunisian population: serological and molecular study].

48 Tunisian people suffering from the IDDM auto-immune disease were compared to 35 control healthy persons for the polymorphisms of the complement BF, C2 and C4 proteins and genes, of the IgG (Gm allotypes) as well as of the TNF alpha and TCR C beta genes. Our study shows that the BFF1-C4A3-C4BQO and BFS-C4AQ0-C4B1 complotypes are associated to IDDM (RR of 2.97 and 3.07 respectively), as previously reported for other circummediterranean populations. The frequency of the Gm 21.28; 1.17; .. haplotype is increased, but not significantly, among the patients. The RFLP analysis reveals that the 2.65 kb SacI allelic restriction fragment of the C2 gene may be considered as a genetic marker of susceptibility to IDDM because its frequency raises to 0.206 among the patients vs 0.021 in the healthy individuals (p less than 0.001). The frequencies of the C4AQ0 and C4BQ0 alleles are more important among the IDDM patients than within the control sample, but the only C4BQ0 allele frequency is significantly increased. Both C4AQ0 and C4BQO result mainly from deletions. The frequencies of the allelic restriction fragments of the TNF alpha and TCRC beta genes are not significantly different among the patients and the controls. But the small sample size don't allow us to conclude definitively. It would be very interesting to extend the RFLP analysis to the TCR V beta and V alpha gene regions on more numerous samples.

Adolescent↗
PubMed1993

Chronic neutropenia associated with C2 and C9 deficiency.

A Japanese male with a deficiency of the second and ninth components of complement associated with chronic idiopathic neutropenia is presented. In this case the second component of complement is totally deficient while the ninth component is approximately half that of normal control. Neutrophil granulocytes are constantly few, but this case shows no evidence of susceptibility to either viral or bacterial infections. His HLA type is different from that of Caucasians, suggesting that the genetic abnormality responsible for the complement deficiency of this Japanese case is different from that seen in Caucasian patients.

Adult↗
PubMed1988

Studies on the formation of a unique cellular intermediate (EAC14256) from EAC142 and C56.

The binding reaction of C56 to EAC142 was studied. The following was observed: (1) C56 can bind to EAC142, without participation of C3 or C7, to form EAC14256; (2) the efficiency of EAC14256 formation from EAC142 and C56 depends highly on the ionic strength of the buffer; (3) EAC14256, generated from EAC142 and C56, decays spontaneously by elution of C56 into the medium and thus the reaction between C56 and EAC142 is reversible; (4) the receptor on EAC142 for C56 is C2 or C42 on the cell surface, and (5) the binding of C56 to C2 or C42 on cells is independent of the usual (C3-dependent) complement cascade activation. These observations, together with the results of our previous report, indicate that the binding of C56, generated from the activation of C5 by C42 (without C3), to EAC142 may be the initial step of membrane attack complex formation in C3-independent immune hemolysis.

Antibodies↗
PubMed1989

Enhanced resolution of the SstI polymorphic variants of the C2 locus: description of a new size class.

Investigation of the SstI polymorphism at the 5' region of the gene encoding the serum complement component, C2, in unrelated individuals has been limited by inadequate resolution of the different size variants using conventional agarose gel electrophoresis. We have overcome this problem by the simple modification of electrophoretic conditions using both low current and temperature. With the technique described in this report it has been possible to assign the hetero- and homozygosities of the SstI polymorphism in unrelated individuals without the need for family studies. Using this approach we have investigated a population of 60 healthy, unrelated Caucasians. Five different variants of the SstI polymorphism, the 2.75-, 2.7-, 2.65-, 2.55-, and 2.4-kb fragments, were observed. The 2.7-kb SstI fragment is the most common variant, followed by the 2.65- and the less common 2.4-kb SstI fragments. These fragments occurred at frequencies of 53.3, 35.8, and 7.5%, respectively. We report here a new rare variant of the 2.75- and another rare variant of the 2.55-kb SstI fragments; both occurred at a frequency of 1.7%. The latter variant was previously described as the 2.6-kb SstI fragment but is reclassified in this report as 2.55-kb, based on the results of better resolution on electrophoresis. All the larger-size classes of the SstI polymorphic variants, the 2.75-, 2.7-, and 2.65-kb fragments, are associated with the 4.5-kb TaqI fragment, while the smaller-size classes of 2.55- and 2.4-kb fragments are associated with the 6.6-kb TaqI fragment at the 3' end of the C2 gene.

Blotting, Southern↗
PubMed1986

The role and mechanism of cobra venom factor-induced suppression of the humoral immune response in guinea pigs.

The cobra venom factor (CVF)-mediated suppression of the humoral immune response to bacteriophage phi X 174, a T cell-dependent antigen, was investigated in guinea pigs. The suppression was markedly dependent on the amount of antigen used: decomplementation of animals diminished the humoral immune response when immunizing with low doses of antigen, whereas increasing the antigenic dose resulted in little or no diminution by CVF. In contrast to the results with normal animals, CVF had no influence on the humoral immune response of genetically C2-deficient guinea pigs; i.e., no suppression occurred above that due to the inherited complement deficiency state alone. We therefore postulate that CVF suppresses the humoral immune response by the depletion of C3, with no measurable role for complement split products under these experimental conditions.

Animals↗
PubMed1983

Phagocytosis inhibits the production of C2 by human monocytes.

Production of the second complement component by cultured human monocytes was suppressed by the addition of a variety of phagocytosable particles. The degree of suppression was related to the concentration of particles, but was unrelated to particle size, the presence of surface sialic acid, antibody or C3b. The failure to reverse suppression by prostaglandin synthetase inhibitors indicates that it is not mediated by prostaglandins.

Cells, Cultured↗
PubMed1986

Bronchoalveolar lavage fluid and serum complement activity in pulmonary sarcoidosis.

In this work, using bronchoalveolar lavage fluids (BALF), we demonstrated the presence of complement within airways by assaying hemolytic activity of the whole classical pathway (CH50) and by measuring the complement component C2 (C2H50). Patients with sarcoidosis, patients with idiopathic pulmonary fibrosis (IPF), and healthy control subjects were compared. No CH50 activity was found in BALF from healthy control subjects (n = 9), but some activity (mean, 20 CH50) was associated with IPF (n = 7). Complement activities ranged from 40 to 554 CH50 in patients with sarcoidosis (n = 27). During the treatment, complement activity decreased in BALF from the few patients in our series who received corticotherapy. C2 hemolytic activity was detected in BALF from the normal control group (in the absence of CH50 activity). In the sarcoidosis and IPF groups when CH50 was present, the variations in the C2/CH50 ratio were studied. The high ratio observed in BALF from patients with sarcoidosis and a chronic derangement of alveolar structure suggests either an increased C2 production or an alternative complement pathway (C2-independent) activation within their lungs.

Adult↗
PubMed1984

Cleavage of C2 in pathological serum and plasma studied by crossed immunoelectrophoresis.

A cleavage product of C2, C2a was demonstrated by crossed immunoelectrophoresis in serum and EDTA plasma from patients with active systemic lupus erythematosus (SLE), patients in the early phase of acute poststreptococcal glomerulonephritis (AGN), and from two males with congenital deficiency of C1(-) inactivator, one of whom had symptoms of hereditary angioedema. C2a was not found in normal serum and plasma. C2 was more stable in plasma than in serum with regard to the effects of storage in room temperature and of repeated freezing and thawing. C2a concentrations were higher in serum than in plasma samples from SLE and AGN patients. Expressed in per cent of the total C2 protein, C2a was inversely correlated (r = -0.91) with the C2 hemolytic activity in the samples, which explains discrepancies between the results of immunochemical and functional assays, when used to measure C2 concentrations in disease.

Adult↗
PubMed1981

Cyclic AMP-mediated modulation of the production of the second component of human complement by monocytes.

The production of the second complement component (C2) by human monocytes in culture was inhibited by increasing their intracellular concentrations of cAMP following the addition to the culture medium of dibutyryl-cyclic AMP, 8-bromo-cyclic AMP, theophylline, isobutylmethylxanthine, cholera toxin or adenosine. The effects were not due to cytotoxicity or loss of cells from the monolayers, and therefore must reflect a decreased synthesis of section of C2. Although dibutyryl-cyclic GMP enhanced C2 production, 8-bromo-cyclic GMP, ascorbic acid and sodium nitroprusside did not have this effect. These observations suggest that the action of dibutyryl-cyclic GMP is not due to elevation of cyclic GMP levels and that cyclic GMP levels do not play a major role in C2 production by monocytes.

Bucladesine↗
PubMed1983

Complement studies in splenectomized patients.

Total haemolytic complement activity, C2, C5, total alternative pathway activity, factor B, and C3d were measured in 85 splenectomized patients from 1 month to 32 years after splenectomy. Furthermore the patients were investigated for circulating immune complexes. No major deficiencies of the complement factors were detected. In a few patients a reduced C2 level was caused by genetically determined defects or was due to complement consumption in conjunction with circulating immune complexes. The complement levels were normal in 2 patients who had survived overwhelming infections after splenectomy. C5 was elevated in a major proportion of the patients, and it is suggested that this might be caused by post-splenectomy monocytosis. Circulating immune complexes were found in 20% of all cases, irrespective of the presence of residual splenic tissue. Thus the commonly cited impairment of the complement system after splenectomy does not seem to be substantiated, and the deficient resistance against bacterial infections in splenectomized patients does not seem to include abnormalities of the complement system.

Adolescent↗