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Complement activation by myeloperoxidase products released from stimulated human polymorphonuclear leukocytes.

Purified human myeloperoxidase (MPO) converted human C5 to an activated form, i.e. the C5 protein adopted a configuration expressing a binding site for C6; the resulting C56 complex then reacted with C7, C8 and C9 forming a hemolytic C5-9 complex. For the activation by myeloperoxidase chloride and hydrogen peroxide were essential. This indicates that the peroxidase acted through the generation of HOCl which had been shown earlier to oxidize and activate C5. Human polymorphonuclear leukocytes (PMN) were stimulated in vitro by incubation with opsonized zymosan; thereafter the supernatants were tested for C5 activating potency. Stimulated PMN release H2O2 and MPO that produces hypochlorite and secondarily various chloramines. As a trap for the labile hypochlorite generated excess taurine was added to the PMN suspensions during the incubation. Hypochlorite is then stoichiometrically converted to the relatively stable taurine chloramine. In order to rule out interfering activities of proteolytic enzymes released from the PMN and known to attack C5, the supernatants were ultracentrifuged, and the ultrafiltrates, containing only low molecular weight compounds, were used for the further studies. They contained taurine chloramine, estimated photometrically, and they activated C5 upon incubation, assayed functionally by reactive lysis. Azide, an inhibitor of myeloperoxidase, and catalase which destroys H2O2, essential for MPO-catalyzed oxidations, prevented the generation of C5 activating potency and of chloramines. Unstimulated PMN produced neither oxidants nor C5 activating potency. When taurine was omitted from the PMN suspensions during stimulations much less oxidant was found in the supernatants and less C5 activating potency. These findings indicate that the C5 activating agent was produced by stimulated PMN through MPO-generated hypochlorite, trapped as taurine chloramine. In the absence of added taurine the hypochlorite formed by MPO oxidized endogenous amines that also activated C5. Further studies suggested that among these was some monochloramine derived from endogenous ammonia. Activation of the terminal complement reaction sequence by MPO released from stimulated PMN may represent a third pathway to complement activation contributing to and reinforcing complement and PMN functions at the site of inflammation or tissue injury.

Complement Activation↗

[Levels of anti-nDNA using immunofluorescence on Crithidia luciliae. II. Prognostic value of complement-fixing anti-nDNA. Longitudinal study of 16 lupus disorders].

Measurements of the hemolytic complement level and titrations of anti dS DNA antibodies by immunofluorescence using Crithidia luciliae and by the Farr binding assay were performed in 13 females and 3 males suffering from systemic lupus erythematosus (SLE). In each patient, 2 to 5 serum samples were analyzed during a mean follow up time of 16.6 months. The complement fixing ability of the anti dS DNA antibodies was also investigated. In this longitudinal study the titers of the dS DNA antibodies detected by immunofluorescence correlated with the Farr binding assay results. Mean anti dS DNA antibody titers were significantly higher and CH 50 levels were lower when SLE was active. Among sera with anti dS DNA antibodies, only sera with high titers (greater than or equal to 1/80), fixed complement. Study of individual cases disclosed that an increase in complement fixing anti dS DNA antibodies could occur in the absence of disease activity. Sera from patients with severe organ involvement, in particular with nephritis had low titers of anti dS DNA antibodies with no complement fixation activity. There was no relationship between falls in serum complement level and the complement fixation ability of anti dS DNA antibodies. Thus, complement fixation capacity of anti dS DNA antibodies correlates better with antibody titer than with SLE severity or activity.

Adult↗

Determination of C3 nephritic factor activity by a microassay based on the peroxidase-like activity of the heme group.

We report a modification of a method for measuring the C3 nephritic factor, using the peroxidase activity of the heme group. This modification increases the sensitivity of the method, approximately seven-fold when NEF activities are measured in U/mL. It is less time-consuming and it allows the simultaneous testing of a larger number of samples, simplifying the screening of sera and ensuring an easy and simple test for the detection of NEF in purification processes as well as in in vitro production. The method could also be useful in other hemolytic assays.

Biological Assay↗

Passive hemagglutination and hemolysis tests for the detection of anti-DNA antibody.

Passive hemagglutination (PHA) and hemolysis (PHL) tests using chromium chloride-treated sheep red blood cells were developed to detect and measure the anti-DNA antibodies. Sonication of native DNA was found to prevent the incidence of non-specific agglutination. Sheep red cells were coated with double-stranded DNA (dsDNA) which had been sonicated and treated with nuclease S1 to digest the single-stranded regions in the DNA. The specificities for dsDNA-coated cells were checked by inhibition studies in PHA test and plaque assay. In clinical studies fairly close correlations were found between the antibodies to DNA and the activity of the disease in patients with systemic lupus erythematosus (SLE). Complement-fixing antibodies were detected in most of SLE patients with active lupus nephritis, but rarely in those in remission. Anticomplementary activity seemed to be negligible in PHL test. These tests are simple and may be useful to the diagnosis and the management of SLE.

Animals↗

Anaphylactoid reactions mediated by autoantibodies to cholesterol in miniature pigs.

Antoantibodies to cholesterol were detected and purified from normal (nonimmunized) pig serum. The antibodies were assayed by ELISA with crystalline cholesterol as an Ag and by C-dependent damage to cholesterol-laden liposomes. Intravenous injection of liposomes containing cholesterol into anesthetized animals caused decreased hemolytic complement titers, and induced a reaction consisting of transient neutropenia, thrombocytopenia, respiratory distress, cyanosis, pulmonary and systemic hypertension, and decreased cardiac output. Plasma levels of thromboxane B2 and 6-keto-prostaglandin F1 alpha increased 1300 and 200%, respectively, and leukocyte and platelet counts decreased by 36 and 38%, respectively. Injection of cholesterol-free liposomes did not induce the reaction. These results show that naturally occurring autoantibodies to cholesterol can initiate C activation and can be associated with anaphylactoid reaction to exogenously administered cholesterol in pigs.

Anaphylaxis↗

Circulating immune complexes in bacillary and amebic dysentery.

In order to study the relationship between the presence of circulating immune complexes (CIC) and the severity and duration of acute dysentery, we studied 11 adults and 45 children in Bangladesh with bacillary and amebic dysentery, using the Raji cell and solid-phase C1q (C1q-SPA) assays. CIC were found in 70% of patients with shigellosis and in all eight cases of amebic dysentery. Mild shigellosis was associated with positive samples in the first week of clinical illness, whereas severe cases, including those with the hemolytic-uremic syndrome, had negative admission assays but positive convalescent assays. Samples positive in the first two weeks of illness were more likely positive by the Raji cell assay alone whereas samples in the third and fourth weeks of illness were positive more often by the C1q-SPA assay. Only one shigellosis sample was positive by both assays. In amebiasis 11 of 13 samples were positive by the Raji assay alone. In dysenteric disease circulating immune complexes probably represents the failure of the inflamed mucosa to exclude microbial and dietary antigens, and suggests that the presence of CIC in any intestinal disease must be interpreted with caution.

Anemia, Hemolytic↗

No direct activation of fluid phase C3 by lymphokines.

Supernatants of stimulated (PPD or Con A) or unstimulated guinea pig lymph node cell cultures in serum-free medium were fractionated on Sephadex G 75. The fractions were tested for C3-consuming activities in a hemolytical assay. No C3 consumption could be detected in any fraction (MW range 80,000 to 10,000). The same result was obtained by extending the fractionation range using Sephadex G 200. A lytic activity with a molecular weight of appr. 225,000 which lysed EAC 14 cells in the presence of C2, 5, 6, 7, 8, 9 was attributed to serum C3 contaminating the cultures. It was determined that C3 is not produced in significant amounts by lymphocyte cultures.

Animals↗

Cold activation of complement as a marker of hepatitis C viremia in sera from blood donors.

Sera from 49,088 blood donors were tested for markers of hepatitis C virus (HCV) infection and decreased hemolytic activity after they had been stored at 4 degrees C for 24 h, a phenomenon known as the cold activation of complement. Antibody to HCV (anti-HCV) was detected in 315 (0.64%) units, of which 181 (57%) were positive for HCV RNA. The cold activation of complement was detected in 170 (0.35%) units, and HCV RNA was detected in 140 (82%) of them. Thus, the cold activation of complement was observed in 140 (77%) of 181 blood units with HCV RNA. The close association of HCV viremia with the cold activation of complement would be useful as a surrogate test in preventing post-transfusion HCV infection in developing areas where anti-HCV assays are not easily performed.

Biomarkers↗

A sensitive haemolytic assay of mouse complement.

Under appropriate conditions the haemolytic activity of mouse complement can be measured in a 51Cr release assay. Modifications that increase the sensitivity are the following: (a) mouse 7 S anti-SRBC antibodies as amboceptor; (b) low amount of target cells; (c) ionic strength of 0.13 M NaCl in the test medium; (d) incubation temperature of 30 degrees C; (e) incubation time of 90 min; (f) total reaction volume of 1 ml.

Animals↗

Probing the structure of C1 with an anti-C1s monoclonal antibody: the possible existence of two forms of C1 in solution.

Anti-human C1s monoclonal antibody H1532, a mouse gamma-1-immunoglobulin elicited by a C1r2C1s2 immunogen, appeared to bind to the beta-domain of C1s by electron microscopy. In agreement with this observation, Western blotting demonstrated good binding to unreduced C1s, but no binding to the alpha or gamma-B domains. When added to solutions of the C1r2C1s2 tetramer, HI532 converted the 8.7 S tetramer into an 18 S complex, which was seen by electron microscopy to be a dimer of parallel C1s x C1r x C1r x C1s molecules cross-linked by two bivalent monoclonal antibodies. If increasing amounts of HI532 were added to C1r2C1s2 followed by addition of equivalent C1q, there was a progressive loss of hemolytic activity, which became zero when two equivalents of antibody HI532 were added. When two equivalents of HI532 were added to serum or C1 reconstituted overnight from purified subcomponents, there was an immediate loss of approximately 50% of the hemolytic activity; thereafter, activity decayed slowly and even after 24 hr, 10-30% of the activity remained. The rapid loss of only 50% of the activity would be readily explained by the existence of two conformations of C1, one of which was rapidly disassembled by antibody, and the other was resistant to disassembly. These two conformations may correspond to two previously proposed structures for the C1 complex.

Animals↗

Increased immunoglobulin-secreting cells in the blood of patients with active idiopathic IgA nephropathy.

Peripheral blood lymphocytes from 33 patients with idiopathic IgA nephropathy (IgAN) and 15 healthy controls were stimulated in vitro by Protein A from Staphylococcus Cowan I; immunoglobulin (Ig) production was measured by a reverse hemolytic plaque assay to evaluate the quantity of cells secreting Ig. In addition, serum Ig levels, circulating IgG, IgA and IgM immune complexes (ICs) and the Fc and C3b receptor mediated phagocytosis of peripheral monocytes were measured. The laboratory findings in different phases of the disease were compared. The mean level of IgA-plaque forming cells (IgA PFC) in IgAN patients with normal renal function was significantly higher (p less than 0.001) than the mean control value. In contrast, they were reduced significantly in those patients who were subjected to periodic hemodialysis (p less than 0.001). Disease activity produced a significant increase in IgG PFC and IgA PFC, high IgG and IgM serum levels, high circulating IgG ICs, and low C3b-mediated phagocytic function of the peripheral macrophages. These findings demonstrate that IgAN is associated with an increased number of IgG and IgA-secreting cells in the peripheral blood of patients during the active phase of the disease and that the concurrent presence of high levels of circulating Ig ICs may be responsible for the gross hematuria, as their deposition in the glomeruli could activate the complement system.

Adolescent↗

White cell-associated procoagulant activity induced by ABO incompatibility.

BACKGROUND: Disseminated intravascular coagulation is an established complication of acute hemolytic transfusion reactions, particularly those involving the ABO red cell (RBC) antigen system. In addition, peripheral blood white cells, particularly monocytes, have demonstrated expression of procoagulant activity (PCA) in response to inflammatory stimuli. To better define the activation of coagulation in immune hemolysis, in vitro experiments were conducted to investigate the expression of PCA by peripheral blood white cells in ABO RBC incompatibility. STUDY DESIGN AND METHODS: Fresh group O heparinized whole blood was incubated with washed, packed group A or O RBCs. White cells were separated, washed, and lysed before assay of PCA, which was measured by a one-stage recalcified clotting time assay. Units of activity were calculated on the basis of a rabbit brain thromboplastin standard curve. Mechanisms of coagulation activation were investigated by using specific coagulation factor-deficient plasmas, blocking antibodies to tissue factor, and anti-CD11b. RESULTS: Significant levels of white cell-associated PCA were found at 2 to 6 hours in response to incompatible (group A) RBCs, but not in response to compatible (group O) RBCs. PCA was not correlated with numbers of platelets in whole blood. Nonimmune lysis of compatible RBCs did not induce PCA. When whole blood reconstituted from washed cells and heat-inactivated plasma was incubated with incompatible RBCs, PCA and hemolysis were abrogated, which suggests that complement is a required intermediate. Protein synthesis inhibition by the addition of cycloheximide (5 mg/mL) to whole blood incubated with RBCs prevented the expression of PCA. Substitution of factor VIII-deficient plasma for normal plasma in the recalcified clotting time assay had no effect, whereas PCA was reduced by 68 percent with factor VII-deficient plasma and was unmeasurable with factor X-deficient plasma. PCA was restored by a 1-to-1 mix of normal and factor VII-deficient plasma. Incubation of samples in the PCA assay with tissue factor antibodies resulted in up to 86-percent inhibition of measured PCA. Titration of the response to the amount of tissue factor antibodies added demonstrated that maximal inhibition occurred with 0.45 mg per mL, above which no further inhibition took place. However, the addition of anti-CD11b (0.75 mg/mL) concomitantly with anti-tissue factor abolished measurable activity. This effect was independent of the amount of added protein, and anti-CD11b alone had no effect on measured activity. The addition to whole blood concomitantly with RBCs of polyclonal antibodies to tumor necrosis factor, sufficient to neutralize 2000 pg per mL, did not alter PCA expression. CONCLUSION: These results indicate that white cell-associated PCA is generated in whole blood in response to ABO RBC incompatibility and may contribute to disseminated intravascular coagulation in acute hemolytic transfusion reactions. Two possible cellular mechanisms are suggested, which involve tissue factor expression and the activation of factor X by a CD11b-dependent mechanism.

ABO Blood-Group System↗

Testing of hemolytic complement components in domestic animals.

Total complement (C) and its components were assayed in the serum of 8 species of domestic animals, using commercially prepared cellular intermediates of sheep erythrocytes and functionally pure guinea pig and human components of the C system. Testing was done according to methods recommended by the producer for testing human C components. The late-acting components (C6 throug C9) and C1 were detected in carnivorous (dog and cat) and omnivorous (swine) animals. Undetectable or low titers of C4, C2, C3, and C5 were present in large herbivorous animals (cattle, horse, sheep, and goat), indicating major differences in comparison with human or guinea pig components of C. Porcine serum contained an inhibiting substance which interfered with testing C2 and later-acting components at serum dilutions up to 1:100. All components except C2 were detected in chicken serum. The binding or activation (or both) of C4, C2, C3, and C5 is more species specific than is the binding or activation (or both) of other components. Requirements for species specificity between antibody and C1 were not detected. Presence of C1 inactivator was detected in bovine, caprine, equine, and ovine sera. The CH50 (50% hemolysis) titers of C components tested in pooled serum samples from the 8 species of clinically healthy domestic animals are presented.

Animals↗

Adult-onset Still's disease. Twenty-year followup and further studies of patients with active disease.

Eleven female patients with adult-onset Still's disease were followed for 7-36 years (mean 20.2 years) after the onset of their illness. Ten of these patients had a chronic course characterized by remissions and exacerbations of arthritis associated with fever and rash. Five patients had terminal interphalangeal involvement, and carpal ankylosis was demonstrated on x-ray film in 10. Two patients developed a widespread polyarthritis, and renal amyloidosis was diagnosed 10 years after disease onset in the most severely affected patient. In 4 patients studied during an exacerbation of the disease, circulating immune complexes were detected by the staphylococcal A binding assay, but not by the C1q binding assay. Synovial fluid analysis in 1 patient revealed a low C3 level and total hemolytic complement (CH50) together with immune complexes and IgG rheumatoid factor. Immune complexes were not identified in the characteristic Still's rash by immunofluorescence or electron microscopy, although mast cell degranulation, neutrophil lysis, and perivascular fibrin deposition were reminiscent of immune complex--mediated vascular injury. The clinical and laboratory features as well as the long-term course of adult- and juvenile-onset systemic Still's disease are similar, but further studies of genetic markers and immunopathology are required to establish a common pathophysiology.

Adult↗

Biological functions of C1q expressed by conformational changes.

Of all the serum proteins C1q is one of the most positively charged. Two dimensional-isoelectric focussing studies revealed an isoelectric point of 9.3. Due to its unique character C1q is able to interact directly with highly negatively charged molecules (e.g. mucopolysaccharides, MPS.) This interaction is ionic in nature as demonstrated by electro-immunoassay. Binding of C1q to immune complexes induces conformational changes. The inhibitory effect of MPS on C1q, as measured by hemolytic assay, provides positive evidence for such conformational changes. The detection of neoantigens further supports this observation. These in vitro studies suggest that the observed autoantibodies against the collagenous portion of C1q in certain SLE patients are induced by long-acting conformational changes within the C1q-immune complex.

Antibodies, Monoclonal↗

B cell activation by pokeweed mitogen in cultures of normal peripheral blood lymphocytes depleted of T regulator subsets by treatment with OKT4 and OKT8 monoclonal antibodies.

OKT4+ (T helper/inducer) and OKT8+ (T cytotoxic/suppressor) subsets were depleted from peripheral blood lymphocytes (PBL) by complement-mediated lysis and residual cells examined for responsiveness to pokeweed mitogen (PWM) using a protein A haemolytic plaque assay for immunoglobulin secreting B cells. It was shown that: (1) three cycles of cell killing were required to totally abolish T helper function; (2) OKT4- PBL did not respond to PWM, but in a co-culture system, an equal number of unfractionated normal PBL could entirely reconstitute responsiveness of the residual B cells; (3) OKT8- PBL gave enhanced numbers of PWM-induced plaque forming cells (PFC); (4) addition of 4 micrograms/ml concanavalin A (con A) to PWM stimulated OKT8- PBL failed to suppress PFC generation, but suppression was induced by 12.5 and 25 micrograms/ml con A and (5) kinetics of PWM-induced PFC development were similar in the presence or absence of OKT8+ cells.

Adult↗

Platelet-associated complement C3 in immune thrombocytopenic purpura.

Platelet-associated C3 (PA-C3) was measured with a quantitative immunofluorescence assay. With this assay, PA-C3 levels were determined for 78 normal volunteers, 30 patients with immune thrombocytopenic purpura (ITP), and 20 patients with nonimmune thrombocytopenias. Platelet-associated IgG (PA-IgG) levels were also measured with our standard quantitative immunofluorescence assay. All patients with nonimmune thrombocytopenias and ITP in remission had normal PA-C3 levels. Twenty-four patients with active ITP were classified into 3 groups: 9 (38%) with increased PA-IgG and normal PA-C3 levels, 10 (42%) with elevated PA-C3 and PA-IgG levels, and 5 (20%) with increased PA-C3 values only. A direct correlation was found between PA-C3 and PA-IgG levels. PA-IgG levels were higher in the group of patients with elevated PA-C3 levels than in those with normal values. Platelet survival studied showed reduced survival times of 1.5--2.5 days for the 5 patients with elevated PA-C3 levels only. Elevated PA-C3 levels returned to normal in 7 ITP patients whose platelet counts increased in response to corticosteroid therapy or to splenectomy. Therefore, PA-C3 and PA-IgG assays can be used to identify patients with ITP, to follow their response to therapy, and to classify them into immunologic subgroups similar to red cell classification by Coombs' testing in immune hemolytic anemia.

Adolescent↗

The C1q-binding cell membrane proteins cC1q-R and gC1q-R are released from activated cells: subcellular distribution and immunochemical characterization.

Two types of widely coexpressed cell surface C1q-binding proteins (C1q-R): a 60-kDa calreticulin-homolog which binds to the collagen-like "stalk" of C1q and a 33-kDa protein with affinity for the globular "heads" of the molecule, have been described. In this report, we show that the two molecules are also secreted by Raji cells and peripheral blood lymphocytes and can be isolated in soluble form from serum-free culture supernatant by HPLC purification using a Mono-Q column. The two purified soluble proteins had immunochemical and physical characteristics similar to their membrane counterparts in that both bound to intact C1q and to their respective C1q ligands, cC1q and gC1q. In addition, N-terminal amino acid sequence analyses of the soluble cC1q-R and gC1q-R were found to be identical to the reported sequences of the respective membrane-isolated proteins. Ligand blot analyses using biotinylated membrane or soluble cC1q-R and gC1q-R showed that both bind to the denatured and nondenatured A-chain and moderately to the C-chain of C1q. Moreover, like their membrane counterparts, the soluble proteins were found to inhibit serum C1q hemolytic activity. Although cC1q-R was released when both peripheral blood lymphocytes and Raji cells were incubated in phosphate-buffered saline for 1 hr under tissue culture conditions, gC1q-R was releasable only from Raji cells, suggesting that perhaps activation or transformation leading to immortalization is required for gC1q-R release. Subcellular fractionation of Raji cells and analyses by enzyme-linked immunosorbent assay and Western blotting showed that the two molecules are present in the cytosolic fractions as well as on the membrane. The data suggest that soluble forms of both C1q-binding molecules are released from cells and that these molecules may play important roles in vivo as regulators of complement activation.

Amino Acid Sequence↗