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PubMed1996

[The effect of hemodialysis with frequent use of cuprophan and polysulfone membranes on activation of complement in patients with chronic renal failure].

UNLABELLED: During haemodialysis in patients with chronic renal failure plasma proteins have contact with dialysis membranes. Complement activation is one of effects of this contact. Intensity of this activation depends on structure of material that the membrane is made of, and it is a determinant of hemocompatibility of dialysis membrane. Our studies were designed to evaluate complement activation during haemodialysis in patients with chronic renal failure and therefore measurements of concentration of C3c factor in serum of hemodialyzed patients were performed. Furthermore, changes in concentration of C3c factor in serum during first and second use of cuprophan and polysulfone dialysis membrane were compared. An artificial kidney Fresenius 4008E, polysulfone dialyzers F5, cuprophan dialyzers C121 and acetate dialysing solution were used in the study. For the purpose of our study we have selected 10 patients hemodialyzed three times a week for 4 hours (5 of them suffered from diabetic nephropathy and the rest of our patients had chronic pyelonephritis) and 10 healthy subjects. Serum concentration of C3c was measured before haemodialysis, in 15', 60' and 240' minute of haemodialysis; measurement were performed on first and second use (after reutilization) of polysulfone and cuprophan membranes, respectively. C3c concentration in blood samples was measured with special reagent kits (turbidometric method). Statistically significant increase of serum C3c level was observed in studied group of patients in 15th minute of first use of cuprophan dialysing membrane. When values of C3c concentration in patients' serum during 60' and 15' of haemodialysis on first use of cuprophan membrane were compared, it was shown that there was a statistically significant decrease of serum C3c level in 60th minute of haemodialysis. RESULTS: 1. Haemodialysis in patients with chronic renal failure is associated with complement activation via the alternative pathway. 2. Maximal activation of complement pathway takes place in 15th minute of the first haemodialysis with use of cuprophan membrane. 3. Usage of the polysulfone dialyzer has no influence on concentration of C3c factor in serum during haemodialysis 4. Polysulfone membranes are characterized with higher haemocompatibility than cuprophan membranes.

Adult↗
PubMed1981

Immunofluorescence patterns in sun-exposed and not-sun-exposed skin of healthy individuals.

Immunofluorescence studies were performed on the sun-exposed (S) and not-sun-exposed (N) skin of 25 healthy volunteers regarding the incidence of the five Ig classes, albumin, fibrinogen, C1q, C4, C3B, C3c, C3d, C5, C3PA and properdin. In addition a comparative study of two so-called anti-complement antisera was made, one (CI) containing anti-(C4+C3a+C3d), the other (CII) anti-(C3B+C3c). In all biopsies the epidermal basement membrane (BM) was stained positively with anti-C3d in a fibrillar, interrupted linear, or granular pattern. A band-like picture of the BM was observed with anti-IgG , anti-albumin and anti-fibrinogen in three biopsies of the S skin. In two other S skin biopsies a lichenoid pattern was found with anti-fibrinogen, anti-C3d and IgM. The latter antiserum caused a weakly positive band-like picture of the BM, occasionally together with granular deposits, more often in the S skin (11) than in the N skin (4). In the capillary walls, granular deposits of IgM, C3d and occasionally C3c were seen in both the S skin (7) and the N skin (13). In the subjacent vessels, globular deposits positive with anti-C3d, C5 and C3c were found predominantly in the S skin. In the M. arrector pili, granular deposits of C3d and, less obviously, C5, properdin and IgM were frequently observed. A band-like, linear, or granular picture of the BM of the adnexal structures was caused by anti-C3d. IgG was found around the sweat gland in about 30%, but the other serum proteins were only rarely present. The IF patterns of the two so-called anti-complement sera showed marked differences, which were apparently caused by the presence of anti-C3d in the CI serum. The significance of these findings for the diagnostic and pathogenetic interpretation of IF results in pathology are outlined briefly.

Adult↗
PubMed1984

Mapping of the properdin-binding site in the third component of complement.

The properdin-binding site in the human third complement component (C3) was mapped by using isolated C3b, C3c, alpha- and beta-chains of C3 and C3 polypeptide fragments and an enzyme-linked-immunosorbent-assay procedure. The C3 chains and the polypeptide fragments were purified to homogeneity by preparative sodium dodecyl sulphate/polyacrylamide-gel electrophoresis. The alpha-chain polypeptides included a 68 kDa and a 43 kDa polypeptide, which were generated by cleavage of C3b with factors I and H, and a 40 kDa, 33 kDa (C3d) and 27 kDa polypeptide, which were generated by cleavage of C3b with porcine elastase. It was shown that properdin binds to C3b, C3c, alpha-chain, and to the 43 kDa (factor-I + H-derived), as well as to 40 kDa (elastase-derived) alpha-chain fragment, but not to the beta-chain 68 kDa, 33 kDa (C3d) and 27 kDa alpha-chain fragments. Thus the binding site for properdin resides on the 40-43 kDa C-terminal alpha-chain fragment of C3.

Binding Sites↗
PubMed1980

Preparation of an R3 reagent (serum depleted of the third component of human complement (C3)) by immunoadsorption. Application to the hemolytic assay of human C3.

We have devised a simple one-step preparation of C3 depleted serum (R3). Fresh normal human serum, with complement activation inhibitors, was depleted of C3 by affinity chromatography on a Sepharose anti-C3c. To prevent non-specific interactions, a high ionic strength buffer containing saccharose was used. Immunochemical analysis and complement activity assays demonstrate that this C3 depleted serum is a suitable R3 reagent. This R3 reagent has been used successfully for titration of hemolytic activity of C3 in normal and abnormal sera. Two simple, specific and sensitive assays are described.

Animals↗
PubMed1996

Specific complement inhibition with heparin-coated extracorporeal circuits.

BACKGROUND: Although it is well established that heparin-coated extracorporeal circuits reduce complement activation during cardiac operations, little in vivo information is available on the reduction in alternative and classic pathway activation. METHODS: In a prospective, randomized study involving patients undergoing coronary artery bypass grafting with standard full heparinization, we compared heparin-coated circuits (Duraflo II) (10 patients) with uncoated circuits (10 patients) and assessed the extent of initiation of complement activation by detecting iC3 (C3b-like C3) concentrations, classic pathway activation by C4b/c (C4b, iC4b, C4c) concentrations, terminal pathway activation by soluble C5b-9 concentrations, and C3 activation by C3a (C3a desArg) and C3b/c (C3b, iC3b, C3c) concentrations. RESULTS: Heparin-coated extracorporeal circuits significantly reduced circulating complement activation product C3b/c and soluble C5b-9 concentrations at the end of cardiopulmonary bypass and after protamine sulfate administration compared with the uncoated circuits, but not iC3, C4b/c, or C3a concentrations. CONCLUSIONS: Heparin-coated extracorporeal circuits reduce complement activation through the alternative complement pathway, probably at the C3 convertase level, and, consequently, the terminal pathway. C3b/c seems to be a more sensitive marker than C3a to assess complement activation during cardiac operations.

Aged↗
PubMed1986

Synthesis of complement components C5, C6, C7, C8 and C9 in vitro by human monocytes and assembly of the terminal complement complex.

Monocytes cultured under serum-free conditions secreted protein which bound covalently and non-covalently to agarose beads, an activator of the alternative pathway of complement. There was a significantly binding of monoclonal anti-C3c antibodies, polyclonal anti-C5, anti-C6, anti-C7, anti-C8, and anti-C9 antibodies, and of a monoclonal antibody against a neoantigen of polymerized C9 to agarose beads incubated with the monocytes for 24, 48, 72 or 96 h. From these results, we conclude that monocytes produce C5, C6, C7, C8 and C9 that assemble as the terminal complement complex on the surface of the agarose beads. Activation by agarose of the alternative pathway with generation of particle bound C3 and C5 convertases is a prerequisite for the subsequent formation of the terminal complement complex. Whether SC5b-9 or the membrane attack of complement (C5b-9) is formed on the beads will be examined.

Antibodies, Monoclonal↗
PubMed1996

Inhibition of human complement by a C3-binding peptide isolated from a phage-displayed random peptide library.

We have screened a phage-displayed random peptide library for binding to C3b, the proteolytically activated form of complement component C3, and have identified a novel peptide that suppresses complement activation. This phage-displayed peptide bound to C3, C3b, and C3c, but not to C3d, indicating that it binds to the C3c region of C3. A synthetic 27-amino acid peptide corresponding to the phage-displayed peptide also bound to C3 and C3 fragments and inhibited both the classical and alternative pathways of complement activation. The inhibition of complement activation was reversible. Studies with overlapping peptides indicated that the functional activity was located in the cyclic 13-amino acid N-terminal region (ICVVQDWGHHRCT) of the parent peptide. Reduction and alkylation of this 13-residue synthetic peptide destroyed its inhibitory activity. Analysis of the mechanism of inhibition revealed that the peptide inhibited C3 cleavage in normal human serum as well as when the alternative pathway was reconstituted with purified complement components, and the observed inhibition was not due to sterically hindered access to the C3a/C3b cleavage site. Further, the peptide did not inhibit the cleavage of factor B, indicating that it did not affect the interaction of CA with factor B or the formation of C3b,Bb. The peptide also had no effect on the binding of properdin to C3, demonstrating that the observed inhibition of C3 cleavage in normal human serum was not due in part to its effect on the properdin-stabilized C3 convertase, C3b,Bb,P. These results indicate that the peptide we have identified interacts with C3 to inhibit its activation.

Amino Acid Sequence↗
PubMed1977

Gingival fluid and serum in periodontal diseases. II. Evidence for cleavage of complement components C3, C3 proactivator (factor B) and C4 in gingival fluid.

1. C3 activation products C3c and C3d can be demonstrated in gingival pocket fluid from patients with severe periodontitis. 2. Quantitatively, C3d levels in GF are comparable to levels attained consequent to immune-complex and tryptic activation of human serum. 3. The alternate pathway of complement activation occurs in the periodontal pocket, as demonstrated by conversion of C3 proactivator (Factor B) to C3-activator Bb. 4. C4 is present in an altered form in some, but not all, GF's. This form is electrophoretically similar to that generated from serum by C1s and several proteolytic enzymes.

Complement C3↗
PubMed1983

Effect of intraocular lenses on complement levels in human serum.

Polymethylmethacrylate intraocular lenses with polypropylene loops were incubated in fresh human serum to determine and quantitate the effect of these lenses on haemolytic levels of C1, C4, C2, C3 and C5 and levels of Factor B and C3c measured by radial immunodiffusion. We were unable to demonstrate any statistically significant differences in complement levels in serum after incubation for 1 h with and without an intraocular lens. After incubation of serum for 3 h with and without an intraocular lens, we were able to demonstrate a statistically significant reduction in C3 by haemolytic assay but not in C3c by radial immunodiffusion. There were no statistically significant differences at 3 h in C1, C4, C2, C5 and Factor B. The results of this study suggest that intraocular lenses do not have a substantial effect on complement levels.

Complement C1↗
PubMed1988

Complement activation during cardiopulmonary bypass: comparison between the use of large volumes of plasma and dextran 70.

Cardiopulmonary bypass surgery may be complicated by a systemic inflammatory reaction, which has been ascribed to the activation of complement. For such activation, the choice of priming solution for the heart-lung machine may be of importance. The peripheral blood of two groups of 10 patients, either exposed to dextran 70 or to plasma as priming solutions, was therefore studied pre-, per-, and postoperatively. The study confirmed that activation of complement is a consistent phenomenon during cardiopulmonary bypass surgery and that the activation involves both the early and the late phase of the complement cascade. The increase in the plasma concentration of the C3 activation products C3c and C3dg was significantly higher in the plasma group than in the dextran group, while there was no difference in the increase in the concentration of the terminal complement complex SC5b-9.

Cardiopulmonary Bypass↗
PubMed1984

Immunologic and biochemical studies on a patient with pyoderma gangrenosum.

A patient with pyoderma gangrenosum without associated disease was studied. Routine investigations showed several abnormalities. High ESR, high alkaline phosphatase and glutamyl transferase (gamma-GT) levels, low iron and iron binding capacity, altered protein spectrum, presence of Staphylococcus aureus and group G hemolytic streptococci in ulcer culture, higher than normal antistreptolysin titers in the serum, and perivascular infiltration in the skin. Biochemical investigations aimed at finding any excessive hydrolytic activity did not reveal the presence of neutral proteases in circulation leaked out from PMN-leukocytes or elsewhere. Lysozyme levels were higher than normal, amylase and lipase levels were normal and 5' nucleotidase levels were below normal range. TCA-soluble polypeptides were present in the serum at levels two times higher than those in normal individuals. Immunochemical investigations showed the absence of immune complexes in the serum but presence of high amounts of C-reactive protein. Total complement activity was higher than normal and so was C3c level. Clq, C4, and C3d levels were within normal range. Biologic studies showed the presence of a factor in patient serum that made guinea pig skin hard, painful, erythematous, and eventually hairless, but not necrotic. A similar factor was either absent in normal serum or present in very low concentration. After salazopyrine treatment, all the above mentioned abnormalities corrected except that 5' nucleotidase activity remained slightly lower than normal, alkaline phosphatase levels remained slightly higher than normal, and C-reactive protein levels remained very high, though lower than those during intense disease activity.

Drug Combinations↗
PubMed1999

Monoclonal antibodies raised against Guillain-Barré syndrome-associated Campylobacter jejuni lipopolysaccharides react with neuronal gangliosides and paralyze muscle-nerve preparations.

Guillain-Barré syndrome and its variant, Miller-Fisher syndrome, are acute, postinfectious, autoimmune neuropathies that frequently follow Campylobacter jejuni enteritis. The pathogenesis is believed to involve molecular mimicry between sialylated epitopes on C. jejuni LPSs and neural gangliosides. More than 90% of Miller-Fisher syndrome cases have serum anti-GQ1b and anti-GT1a ganglioside antibodies that may also react with other disialylated gangliosides including GD3 and GD1b. Structural studies on LPS from neuropathy-associated C. jejuni strains have revealed GT1a-like and GD3-like core oligosaccharides. To determine whether this structural mimicry results in pathogenic autoantibodies, we immunized mice with GT1a/GD3-like C. jejuni LPS and then cloned mAb's that reacted with both the immunizing LPS and GQ1b/GT1a/GD3 gangliosides. Immunohistology demonstrated antibody binding to ganglioside-rich sites including motor nerve terminals. In ex vivo electrophysiological studies of nerve terminal function, application of antibodies either ex vivo or in vivo via passive immunization induced massive quantal release of acetylcholine, followed by neurotransmission block. This effect was complement-dependent and associated with extensive deposits of IgM and C3c at nerve terminals. These data provide strong support for the molecular mimicry hypothesis as a mechanism for the induction of cross-reactive pathogenic anti-ganglioside/LPS antibodies in postinfectious neuropathies.

Animals↗
PubMed1986

Nonionic contrast medium: effects on blood coagulation and complement activation in vitro.

A nonionic contrast medium was evaluated in vitro for its effects on coagulation and complement activation in comparison to a low osmolal contrast agent. In clotting assays each contrast medium was mixed with blood and clotting parameters were analyzed by using a thromboelastographic machine. Platelet function was studied by incubating platelet-rich plasma with individual contrast medium, and the subsequent challenge of a platelet aggregating agent. Complement activation was assessed by the hydrolysis of C3 protein into C3c fragment in contrast medium-incubated serum. Immunoelectrophoresis was used to detect C3c protein. Both the nonionic contrast medium and the low osmolal contrast agent acted as anticoagulant and antiplatelet agents, however, results with the low osmolal contrast agent were more pronounced compared to the nonionic contrast medium. Even at nonphysiologic concentration of contrast medium, no significant conversion at C3 to C3c was seen. Since these two agents caused hypocoagulable states in vitro, it is likely that patients with thrombocytopenia, severe liver disease and with clotting factor deficiencies may present hemostatic complications during angiographic procedures.

Blood Coagulation↗
PubMed1985

Location of the inter-chain disulfide bonds of the third component of human complement.

Location of the disulfide bonds connecting three polypeptide chains (alpha 3, 27kd; 2, 43kd; beta, 75kd) of C3c has been investigated by partial reduction with cysteine followed by alkylation with 14C-monoiodoacetic acid. Treatment of C3c with cysteine produced a partially reduced fragment, composed of disulfide-linked beta and alpha 3 chains. A single thiol residue was detected on the alpha 3 chain but not on the beta chain of the fragment, suggesting that the alpha 2 chain in C3c is linked through a single disulfide bond to the alpha 3 chain but not to the beta chain.

Complement C3↗
PubMed1988

Human peritoneal macrophages. Production in vitro of the active terminal complement components C5 to C9 and a functional alternative pathway of complement. Brief report.

Endotoxin-stimulated human peritoneal macrophages were cultured in serum-free medium with agarose beads. Monospecific antibodies to human C3c, C3g, C5, C6, C7, C8, C9 and to C9-neoantigen bound to the beads. This shows that activated C3 and the terminal complement complex (TCC), made from complement components C5 to C9, were generated on the beads. De novo synthesis was confirmed by agarose binding of tritium-labelled protein. Moreover, C3-derivatives and C9-neoantigen were detected on normal serum-treated agarose beads but not on beads kept in factor B-depleted or heat-inactivated sera, implying that an intact alternative complement pathway was required for our findings. The macrophages thus synthesize the active complement components of the alternative and terminal pathways in vitro.

Ascitic Fluid↗
PubMed1985

Generation of the bioactive kallikrein-derived fragment, C3d-k, by HANE-plasma.

Recent studies have concluded that after complement activation the final physiologic degradation products of C3 are C3c and the fragment of relative molecular mass (Mr) 42,000 which contains the C3d and C3g domains and was therefore named C3d,g. Using fluorescent labelled C3b as a substrate, we have determined the putative C3d,g ('C3d,g') producing activity of both normal and hereditary angioneurotic oedema (HANE) plasmas. In normal plasmas, the rate of production of C3d,g was 1.0 +/- 0.2 X 10(-10) mol/ml/h and this activity was blocked by antibodies to I. In contrast, HANE, plasmas (deficient in C1INH) showed more than twice as much 'C3d,g' production as normal plasmas and both antibodies to I and kallikrein were required to inhibit this activity. Because of this result, a more sensitive gel system was employed to detect the Mr 42,000 peptide and two 'C3d,g' fragments of approximately equal intensity with Mr of 42,000 and 43,000 were defined. Incubation of purified kallikrein with labelled iC3b produced a C3d,g-like fragment, C3d-k, that aligned with the band of 43,000 Mr generated in HANE plasma. These results indicate that HANE plasma, in contrast to normal plasma, generates the bioactive C3d-k fragment. C1INH blocks the activities of kallikrein and C1s, and C3d-k generation in HANE plasma is probably secondary to the proteolytic activity of kallikrein.

Angioedema↗
PubMed1988

Effect of a new nonionic contrast agent, ioxilan, on human erythrocytes and the hemostatic and serum complement pathways.

A new nonionic contrast medium (CM), ioxilan, was compared with iohexol and iopamidol. Following incubation of whole heparinized blood with CM, the morphology and osmotic fragility of erythrocytes were studied, the former by transmission electron microscopy. Effects on platelets and hemocoagulation were determined by standard hematologic procedures. Effects on serum complement were evaluated by measurement of total hemolytic complement (CH50), C3, C4 consumption and the presence in serums of C3c as determined by immunoelectrophoresis. Ioxilan affected the erythrocyte membrane less than iohexol and iopamidol: the latter two produced acanthocytes, whereas ioxilan had no effect on erythrocyte morphology; also, erythrocytes exposed to ioxilan (and iopamidol) were more resilient to hypotonic saline solutions than those exposed to iohexol. In all tests, all CM showed anticoagulant activity, albeit much less when compared with ionic CM. At equal iodine concentration, ioxilan reduced the platelet aggregation and whole blood clotting time more than did iohexol. None of the CM activated the serum complement system.

Complement Activation↗
PubMed1986

Complement activation in cystic fibrosis respiratory fluids: in vivo and in vitro generation of C5a and chemotactic activity.

Experiments performed in vitro have demonstrated that leukocyte neutral proteases produce an important mediator of inflammation, C5a, by proteolysis of the C5 component of the complement system. Cystic fibrosis (CF) lung fluids were characterized by high levels of neutrophils (39% of total cells versus 2% in normals) and contained significantly elevated amounts of elastolytic activity (mean 17.7 ng/micrograms total protein) compared to the lung fluids obtained from normal volunteers (0.2 ng elastolytic activity/micrograms protein, p = 0.001). The objective of these studies was to determine if complement activation and complement-derived chemotactic activity are present in CF lung fluids. C3c peptide representing activation of C3 could not be identified in the bronchial-alveolar lung lavage fluids of normal subjects but was readily identified by means of crossed immunoelectrophoresis in CF lung fluids (n = 9, mean 49% of C3); the mean level of C3 was decreased in CF lung specimens. Chemotactic activity was significantly elevated in lung fluids of the CF patients when compared to normal lung fluids. Using gel-filtration chromatography and a sensitive radioimmunoassay the chemotaxin present in CF specimens was identified as the anaphylatoxin C5a. C5a levels in the bronchial-alveolar lavage fluids of CF patients was inversely related to volume in liters expired in 1 s of a forced expiratory maneuver expressed as a percent of vital capacity determined from a forced expiratory maneuver (r = -0.72). Because there was a direct relationship between the total elastolytic activity present in CF airways and the concentration of C5a (r = 0.97, p = 0.03), it was postulated that airway proteases with elastolytic activity also cleave C5, nonimmunologically producing C5a. Detailed inhibition assays revealed that much of the total elastolytic activity had the inhibition profile of a serine proteinase. The levels of the serine proteinases were closely correlated with the numbers of neutrophilic leukocytes present per ml of lavage fluid (r = 0.7, p = 0.05). However, inhibitors of leukocyte serine proteases did not prevent the generation of additional chemotactic activity and the proteolysis of radiolabeled C5 substrate was not prevented by inhibitors of neutrophil elastase. Although the purified metalloelastase of Pseudomonas aeruginosa was active on cell-bound and free C5 yielding C5a, inhibition of this bacterial protease in CF lung fluids only partially blocked cleavage of the alpha- and beta-chains of C5.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗