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Coagulation factor XIII: a useful polymorphic genetic marker.

The plasmas of two groups of subjects were examined for blood coagulation Factor XIII-A (FXIII-A, F13A) by electrophoresis in agarose using a Tris-EDTA-borate buffer to separate the common variants, F13A*1, F13A*2, and F13A*3. Dimeric subunits were visualized in UV light as monodansyl cadaverine bound to casein at the position of the transglutaminase activity representing F13A. One test group consisted of 307 members of three large Caucasian families. The other consisted of 148 consecutive patients whose plasmas had been sent to the clinical laboratory for determination of prothrombin time. Segregation analysis and father-to-son transmission confirmed that F13A is inherited as an autosomal co-dominant trait. The allelic frequencies in the random sample were F13A*1 = 0.82 and F13A*2 = 0.18. This sample included both blacks and whites, and the gene frequencies were not significantly different in the two races. The gene frequencies among the unrelated spouses of the three white families were A*1 = 0.75, A*2 = 0.24, A*3 = 0.01. Genetic equilibrium was present in both groups. The degree of polymorphism, the availability of blood, the ease of assessment, the absence of selective pressure, and the uniformity of gene frequencies in two major American ethnic groups make F13A a very useful marker for linkage studies and paternity testing. F13A has been provisionally assigned to chromosome 6. Linkage analysis of our family data did not provide evidence of linkage to two chromosome 6 markers, properdin factor B (BF) and glyoxalase 1 (GLO). The highest lod score (Z) was between F13A and the Kidd (Jk) blood group (theta = 0.68 at = 0.24).

Alleles↗

A new BF F variant by polyacrylamide gel isoelectric focusing.

Polyacrylamide gel isoelectric focusing followed by electroblotting with enzyme immunoassay was done for the investigation of allotypes of properdin factor B (BF) in serum from 326 Japanese subjects. A new BF F variant tentatively designated BF*Fb1 (b = basic) was detected, the isoelectric point of each band of homozygous BF Fb1 being higher than of BF FF. Family data were in accordance with transmission by mendelian inheritance. The allele frequencies calculated from 326 Japanese subjects were 0.7945, 0.1825, 0.0215, and 0.0015 for BF*S, BF*F, BF*Fb1, and BF*F075, respectively, with that of variant BF*Fb1 being a polymorphic frequency. The distribution of phenotypes fitted the Hardy-Weinberg equilibrium.

Alleles↗

Two subtypes of BfF by isoelectrofocusing: differential linkage to other HLA markers.

By isoelectrofocusing in agarose, the properdin factor allotype BfF could be split into two subtypes: BfFa with one major cathodic band and BfFb with the same cathodic band but in addition a major anodic band. By scanning, BfFaFb heterozygotes were distinguished from BfFbFb homozygotes by the stronger intensity of the anodic band in the latter. The two subtypes were segregated perfectly with HLA in 40 families and showed different association patterns with HLA markers. BfFa seemed to be linked to B35 while BfFb showed a strong linkage with all the components of the following haplotype: HLA-A29, Cw-, B44, BfFb, C4A3B1, DR7. The frequency of BfFa among BfFS heterozygotes was 41% (46/113) and that of BfFb 59% (67/113).

Alleles↗

Two new Bf S subtypes revealed by isoelectric focusing and immunofixation.

The genetic types of the properdin factor B were analyzed by isoelectric focusing on polyacrylamide gels and subsequent immunofixation. Sera from 516 unrelated, healthy individuals from Southern Germany were examined. Two new subtypes of the Bf*S allele were observed. They were provisionally named Bf*Sb1 and Bf*Sb2(b = basic), since the position of their bands is located slightly towards the cathode. Whereas Bf Sb2 has, thus far, been found only in a single individual, Bf Sb1 was found in five unrelated persons and in a mother and her child indicating a simple codominant mode of inheritance. The combined frequency of the Bf*Sb alleles was calculated to be 0.0067.

Alleles↗

The HLA linkage group and disease susceptibility.

The HLA linkage group, located on chromosome 6, is composed of serologically defined (SD-) loci (HLA-A, -B and -C) and of a MLC (= mixed lymphocyte culture-) or lymphocyte defined (LD-) locus (HLA-D). Different alleles of these loci are linked together as well as with loci for the synthesis of some complement components and the properdin factor B (= Bf-system) by strong positive linkage disequilibria (gametic association). The indication of a HLA linked genetic control of immunoresponsiveness makes the HLA system one of the biologically most important immunogenetic systems in man. The associations, found between single HLA determinants and diseases, can be explained in different ways, but may contribute to a better understanding of the etiopathogenesis of diseases and of the biological role of the HLA linkage group.

Alleles↗

Lewy bodies in Parkinson's disease are recognized by antibodies to complement proteins.

The substantia nigra (SN) in 11 Parkinson's disease (PD) patients and 5 neurologically normal controls was examined immunohistochemically using antibodies to various proteins of the complement system. In PD, but not in control SN, intra- and extraneuronal Lewy bodies and dendritic spheroid bodies were stained with anti-human C3d, C4d, C7 and C9 antibodies, but not with antibodies to C1q, fraction Bb of factor B or properdin. Axonal spheroid bodies in the nigrostriatal tract were not stained by any of the complement antibodies. However, complement-activated oligodendroglia were revealed by anti-C3d and anti-C4d antibodies in the PD substantia nigral area. These data indicate that some pathological structures in PD activate the classical complement pathway.

Aged↗

Relation of clinical activity of rheumatoid arthritis to immune complexes, complement components and anti-immunoglobulins.

Circulating immune complexes by fluid phase Clq binding assay, complement components and anti-immunoglobulin levels were studied in sera of 35 patients with rheumatoid arthritis (RA). In 23 of the 35 sera (65.7%), circulating immune complexes were positive, and the mean +/- SD of Clq binding activity (ClqBA), 44.5 +/- 19.4%, was significantly high compared to that of healthy persons, 17.4 +/- 8.2%. Antigenic determination of complement components revealed that Clq, C3, C5, C9, factor B and Cl esterase inhibitor (ClINH) were significantly high in sera of RA, but C4 and properdin were not. The disease activity correlated with ClqBA, IgG- and IgM-anti-immunoglobulins, C9 and serum IgG. On the other hand, ClqBA correlated with both IgG- and IgM-anti-immunoglobulin levels but not with complement components.

Adolescent↗

Immunoglobulins and complement factors in senile plaques. An immunoperoxidase study.

Immunoperoxidase techniques were used to obtain information about the possible presence of serum factors in senile plaques. We found only in plaques consisting of an amyloid core surrounded by a corona of degenerating neurites small amounts of IgG and light chains (kappa and lambda). These immunoglobulins were principally localized in the corona and not in the central amyloid core. Further it was found that all plaques contain the complement factors C1q, C3b, C3c, C3d and C4. Senile plaques lacked C5, C3 pro-activator and properdin. The possible significance of these findings in the genesis of the senile plaques and amyloid formation is discussed.

Alzheimer Disease↗

Complement profiles in acute post-streptococcal glomerulonephritis.

It is well known that the hypocomplementemia of acute post-streptococcal glomerulonephritis (APSGN) is characterized by markedly reduced serum concentrations of C3 and moderately reduced levels of C5 and properdin (P). However, the extent of the activation of the classical pathway is not well defined and only limited data are available concerning serum concentrations of terminal components other than C5. In serial serum specimens from 14 children with APSGN, the presence and extent of C4 activation was directly assessed by measurement by rocket immunoelectrophoresis for C4 and C4 (C4d/C4 ratio). Elevated values for this ratio, indicating C4 activation, were found in 8 of 14 of the initial serum specimens, and in some patients the ratio remained elevated for several weeks. In contrast, the serum C4 level was low in only 1 specimen (the specimen with the highest C4d/C4 ratio). However, in 10 patients C4 concentrations within the normal range rose in serial serum specimens. Serum C2 concentrations were depressed in the initial specimens from 5 patients. The concentrations of 13 other complement component and control proteins were also measured in these specimens. Levels of terminal components, other than C5, in the initial serum specimens were normal except for depressed C8 in 3 of 13 patients and depressed C6 in 1 of 14. Of these 4 individuals, 3 had the lowest C3 levels in the study. It is concluded that the classical complement pathway is frequently activated in patients with APSGN early in the condition and that subtle abnormalities in C6 and C8 levels occasionally occur.

Adolescent↗

Combined homozygous factor H and heterozygous C2 deficiency in an Italian family.

Three of four children in a family have homozygous (less than 1% of normal) deficiency of factor H of the complement system and both parents, who are first cousins, are heterozygous for the same defect. The father and two of the H-deficient siblings also have a partial C2 deficiency. One of the children with combined deficiencies is affected by systemic lupus erythematosus with nephritis. No increased susceptibility to infections has been observed in the family. H deficiency is inherited in an autosomal codominant manner and is independently transmitted from C2 deficiency and HLA haplotypes. In the homozygous state it is associated with very low serum concentrations of B and C3, barely demonstrable as activated molecules. C5 is greatly reduced (less than 5%). Also, properdin and C6-9 are decreased. The findings in this family demonstrate that the occurrence of systemic lupus erythematosus in one of the children affected by a combined deficiency of factor H and C2 raises the question whether this pathology is related to the complete factor H or to the heterozygous C2 deficiency. Complete H deficiency is not necessarily accompanied by overt illness.

Child↗

Potential various appearances of hyperacute rejection in human liver transplantation.

Out of 81 liver transplantations 2 graft failures were diagnosed to be due to hyperacute rejection. In the first patient the operative procedure was difficult requiring 19 units of blood and plasma, but the graft was functioning well from the beginning until day 1-2, when rapid deterioration occurred. The cross-match was positive. The second patient received a third graft after the first graft had failed due to donor reasons and the second AB0-incompatible graft had been rejected. The third graft transplanted in an uncomplicated operation requiring only 10 units of blood and plasma failed within hours. Both incidences are thought to be a consequence of an immunological assault, consistent with hyperacute rejection. Thus two different clinical appearances could be observed: the so-called delayed type in the first patient and the more classical type in the second patient. For establishing diagnosis of hyperacute rejection two prerequisites were considered essential: 1) histological findings of necrosis and patchy deposits of immunoglobulins, namely IgG, IgM, IgA, C-3 complement component, properdine and fibrinogen, and 2) the proof of at least a short period of an initial function of the graft prior to deterioration in order to exclude primary non-function due to other causes. The low frequency of the appearance of the classical hyperacute rejection and hypothetical causes for the more frequent appearance of the delayed type are discussed.

Adult↗

Role of serum complement, immunoglobulins, and cell-mediated immune system in the pathogenesis of spontaneous bacterial peritonitis (SBP).

Spontaneous bacterial peritonitis (SBP) is a common complication of advanced liver disease, which has a reported prevalence of between 4 and 27%. Frequent bacteremias due to inadequate host defense mechanisms, particularly the reticuloendothelial system (RES), with seeding of an ascitic fluid that lacks a normal opsonic activity, is believed to be the principal cause of SBP. Little data exist as to the role of serum levels of complement and immunoglobulins as well as the cell-mediated immune system in the pathogenesis of SBP. The aim of this study was to determine the serum levels of the third and fourth components of complement (C3, C4), total hemolytic complement activity (CH100), and properdin factor B (PFB) and immunoglobulins G, A, and M and various T-cell parameters in individuals admitted to hospital with ascites and advanced liver disease and to determine whether one or more of these factors could be used to predict the development of SBP in patients with advanced liver disease. Fourteen consecutive patients (nine male and five female; age 47.5 +/- 3.1 years, mean +/- SEM) with end-stage liver disease and ascites, who were evaluated for possible liver transplant at the University of Pittsburgh and who developed SBP, comprised the study group. The diagnosis of SBP was determined by positive ascitic fluid culture (three patients) and/or ascitic fluid neutrophil count of greater than 250 cells/mm3 (all patients). The control group consisted of 14 patients, matched for type of liver disease, age, and sex, who did not develop SBP.(ABSTRACT TRUNCATED AT 250 WORDS)

Ascites↗

BF types and the mode of inheritance of insulin-dependent diabetes mellitus (IDDM).

Insulin-dependent diabetes mellitus (IDDM) has been found to be highly associated with a rare allele of the complement protein, properdin factor B (BF). Assuming that there is a susceptibility gene for IDDM tightly linked to the genetic locus for BF and the major histocompatibility complex (MHC), the distribution of BF types in more than 1100 North American IDDM patients strongly argues for the rejection of dominant, epistatic, and overdominant modes of inheritance. Other evidence suggesting complex modes of inheritance for IDDM is reviewed and it is concluded that our observations and published data are consistent with the idea of susceptibility to IDDM being inherited as a simple autosomal recessive trait. C4 and C2 types, also linked to BF and the MHC, were investigated too. C4 Fs0 was found to be increased in association with BF F1, while C4 f0S and C2 b were each found to occur twice as frequently as in a control population and will be of value in defining haplotypes associated with susceptibility to IDDM.

Alleles↗

Cryoglobulinaemia in a patient with Proteus mirabilis sepsis.

Mixed polyclonal cryoglobulinaemia was evidenced in a 49-year-old woman admitted to our hospital because of Proteus mirabilis sepsis associated with polyarthralgia and purpuric manifestations on the lower limbs. Cryoglobulins and circulating immune complexes decreased during the second week of illness and disappeared after recovery. CH50, C3 and properdin factor B, which were low during the early phase of the illness, returned to normal; C4 was normal throughout. The rapid clearance of cryoglobulins and immune complexes and the restoration of a normal complement profile might all be explained by the gradual elimination of P. mirabilis due to chemotherapeutic treatment.

Complement C3↗

Immune complex p24 antigen: a new prognostic marker in human immunodeficiency virus infection.

p24 antigen (p24 Ag) is usually not found in patients in the asymptomatic phase of HIV infection, mainly because it is bound to anti-p24 antibodies (p24 Ab), with which it forms immune complexes. Nine asymptomatic patients positive for HIV-1 antibodies (stage II CDC criteria) treated with r alpha-interferon were followed (7.5 +/- 0.5 months), and a basal and final sample were tested for p24 Ag immune complexes (p24 Ag-IC), free p24 Ag, p24 Ab, CD4 count, beta 2-microglobulin, properdin B factor, and C3 and C4 complement fractions. p24 Ag-IC was detected in 55.5% of the samples, whereas free p24 Ag was detected in 5.5%. The finding of no change or an increase in p24 Ag-IC serum levels may be considered a prognostic marker. We believe that p24 Ab cannot be used as a prognostic marker unless p24 Ag-IC detection is simultaneously evaluated.

Antigen-Antibody Complex↗

Effect of a protein-bound polysaccharide PS-K on the complement system.

A protein-bound polysaccharide from mycelia of Coriolus versicolor PS-K, clinically used as an immunomodulator, has been shown to restore the decreased cellular immune response and to exhibit host-mediated antitumor activity. In this experiment, PS-K was found to increase serum complement level in guinea pig and in human without malignancy, when hemolytic assay of complement was performed using sensitized sheep erythrocytes for the classical pathway activity and unsensitized rabbit erythrocytes for the alternative pathway activity. Assay of complement components revealed increase in C3 level in guinea pig, but no significant changes in C1q, C4, C3, properdin, C3 activator, and C1-inhibitor in human, while C5 and C9 were depressed. Conversion of beta 1C to beta 1A was observed in the 7th day's plasma of these patients by crossed immunoelectrophoresis. Biosynthesis of guinea pig C3 was accelerated by administration of PS-K, but that of C4 was not affected. These evidences suggested that PS-K might potentiate immune response of the host by elevating serum complement level, in addition to the activation of the complement system.

Animals↗

Modulation of the formation of the human C-3 amplification convertase of complement by polyelectrolytes.

Heparin in the fluid phase inhibits generation of the C3 amplification convertase of complement C3b,Bb. The anticomplementary activity requires the presence of O-sulfate groups on the molecule and is suppressed when the negative charges of heparin are neutralized with positive charges on polycations. In the absence of heparin, polycations inhibit generation of the cell-bound or fluid phase amplification convertase at final concentrations of 1 to 2 x 10(-8) M for poly-L- lysine 50,000 (PLL). PLL is more active on the D-dependent convertase C3b,Bb than in preventing generation of C3b,B; it does not alter the stabilizing effect of properdin. As for heparin, the major site of the inhibitory action of polycations is on the binding capacity of C3b for B. The low affinity interaction of C3b and B is a privileged site for potential pharmacologic modulation of the amplification convertase of complement by polyelectrolytes.

Binding Sites↗