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[Partial properdin deficiency revealed by a septicemia caused by Neisseria meningitidis].

Properdin is one of the regulatory proteins of the alternative pathway of the complement system. Human properdin deficiency is an X-linked disorder strongly predisposing to meningococcal disease. Total deficiency (type I), partial deficiency (type II), and deficiency due to a dysfunctional molecule (type III) can be differentiated immunochemically. Four males in a family showed a selective partial deficiency of properdin. These individuals had 10% of normal properdin concentration in plasma, as measured by ELISA, while the other complement components were normal. Two of the properdin-deficient individuals in two generations had meningococcal infections. Two were clinically healthy at the time of investigation. Measurement of plasma levels of properdin has to be performed in the case of Neisseria meningitidis, especially where there is a previous history of severe bacterial infections in the same family as measurement of CH50 activity is ineffective for screening properdin deficiency.

Bacteremia↗

Further mapping of the properdin deficiency gene in a Tunisian Jewish family--evidence for genetic homogeneity.

The properdin deficiency gene has been localized to Xp21.1-Xcen; however, it is not clear whether the mutation responsible for the disease co-maps exactly with the structural properdin gene. Based on a recent study on a total of six families, the gene was found linked to DXS255 (theta = 0.00). As only a few families have been studied, it is not known whether the same gene is responsible for the disease in all families. In order to better localize the disease gene in Israel, we studied a Tunisian Jewish family with properdin deficiency for linkage with various X-markers. A maximum lod score of 1.93 at theta = 0.00 was calculated with the DXS7 probe while there was one recombination with DXS255. This study helps to better localize the properdin deficiency gene to Xp11.3-p21.1 proximal to DXS255 locus and confirms that there is no indication of genetic heterogeneity. Whether the properdin structural gene (PFC) and properdin deficiency locus are one and the same await demonstration of mutations in the structural gene in patients with properdin deficiency.

Chromosome Mapping↗

Properdin, a positive regulator of complement activation, is released from secondary granules of stimulated peripheral blood neutrophils.

Properdin is an important regulatory constituent of the complement system. In contrast to most other components of complement, biosynthesis of properdin is restricted to a few cell types only, i.e., monocytes/macrophages and peripheral blood T cells. This report demonstrates the presence of properdin mRNA in peripheral blood granulocytes and shows that properdin is stored in the granules of human neutrophils and secreted upon stimulation with TNF-alpha, C5a, IL-8, or FMLP. Subcellular fractionation using Percoll density gradients and Western blot analyses revealed that the bulk of properdin is contained in the secondary granules. Moreover, flow cytometric analyses indicated that properdin is present on the surface of neutrophils. In contrast to alternative pathway components, components of the classical pathway of complement activation, such as C2 and C4, were not detected. Our findings suggest that neutrophils can actively stabilize and amplify the alternative activation pathway of complement by secretion of properdin as part of the innate defense against microorganisms.

Cell Compartmentation↗

Resolution and analysis of 'native' and 'activated' properdin.

A rapid and reproducible procedure for the resolution of 'native' and 'activated' forms of properdin (a component of the alternative activation pathway of complement), by gel filtration on the polyvinyl matrix Fractogel TSK HW-55(S), is reported. This fractionation permitted effective screening of samples for conditions that cause activation. Only 'native' properdin was detected in serum, even after activation of the alternative pathway by yeast cell walls. Transformation of 'native' into 'activated' properdin in vitro was produced by freeze-thawing of the protein, but not upon binding to and dissociation from the C3 convertase, C3bBb. Electron microscopy showed that only the 'native' population contained the discrete cyclic structures described previously by Smith, Pangburn, Vogel & Müller-Eberhard [(1984) J. Biol. Chem. 259, 4582-4588]. 'Activated' properdin, which was eluted from the gel-filtration column close to the breakthrough peak, was mainly composed of large amorphous aggregates. We therefore conclude that properdin 'activation' is not a physiological event that occurs in serum on complement activation, but is an artifact of isolation. Fractionation of properdin on Fractogel TSK HW-55(S) has, however, enabled detailed analysis of functional heterogeneity within the 'native' population.

Cell Wall↗

Elevation of properdin levels in mice following administration of bacterial lipopolysaccharides.

The administration of a single small dose of bacterial lipopolysaccharide produces in mice a considerable rise in properdin levels. This is accompanied by an early, transient, non-specific increase in resistance to certain bacterial infections. Bacterial lipopolysaccharides were shown to possess far greater activity than other substances previously studied in bringing about an elevation of properdin levels. After the injection of bacterial lipopolysaccharides, high molecular weight substances appear in the circulation, which interfere with the combination of properdin with zymosan and thus affect the assay of properdin. The administration of small amounts of bacterial lipopolysaccharides to mice at appropriate times before experimental infection "conditions" the mice so that they maintain normal or elevated properdin titers during the infectious process in contrast to control mice which show a progressive decline in properdin to low levels and death. The significance of this observation and its relationship to natural resistance to Gram-negative pathogens are considered.

Animals↗

Alternative pathway of complement: demonstration and characterization of initiating factor and its properdin-independent function.

A novel component of the properdin system has been discribed which represents a heretofore unrecognized human serum protein. The protein has been tentatively termed the initiating factor (IF) because it functions in the initial reaction of the properdin pathway. IF is a 170,000 dalton beta-pseudoglobulin which is composed of two presumably identical 85,000 dalton chains linked by disulfide bonds. The protein reacts with antibody to nephritic factor, which is defined by its activity and is found in the serum of patients with certain nephritides. The activity of IF is heat stable. Upon treatment of serum with activators of the alternative pathway, the initial C3 convertase is assembled from IF, Factors D and C, C3, and magnesium without participation of properdin. It is the function of the enzyme to deposit C3b on the surface of the activator particles, thereby affording generation of the solid phase enzymes of the pathway, a process that is a prerequisite for properdin activation. By exposure to low pH, IF assumed the electrophoretic mobility of psi-globulin and acquired the ability to generate without activators a fluid phase C3 convertase in serum. Serum depleted of IF did not allow activation of the properdin pathway. Serum depleted of properdin did permit activation of the pathway and expression of cytolytic activity. These results raise the possibility that IF represents the recognition unit of the pathway.

Animals↗

Fulminant meningococcal septic shock in a boy with combined inherited properdin and protein C deficiency.

A 7-year-old patient with fulminant septic shock due to Neisseria meningitidis of the uncommon serogroup Y developed extensive gangrene of the limbs. Multiple amputations were necessary and a pulmonary embolism occurred within 2 days post-operatively. Complement and haemostatic system studies, done after recovery, showed a complete absence of properdin antigen and a low protein C antigen and activity level in plasma. Defective haemolytic activity in gel by the alternative pathway of complement activation could be restored with purified properdin, indicating a properdin deficiency type 1. Protein C antigen level as well as activity were in agreement with a protein C deficiency type I. The polymerase chain reaction (PCR) product of exon five of the protein C gene showed a substitution of 72Gly by Arg. Both deficiencies were traced among relatives of the patient. Serum of the father of the patient's mother was also properdin-deficient. Microsatellite haplotyping of the X-chromosome of the patient and his relatives showed that a distinct haplotype cosegregated with the properdin deficiency (Lodscore 2.25; four informative meioses). The protein C type I deficiency was present in the patient's mother and her mother and cosegregated with the mutation found. So far as is known, this is the first patient described with combined inherited properdin deficiency and protein C deficiency.

Adult↗

Opsonization of group B streptococci in properdin deficient serum.

Phagocytic killing of group B streptococci serotypes Ia, Ib, IIR- (R protein negative), IIR+ (R protein positive), IIIR- and IIIR+ by human granulocytes was studied after opsonization in properdin deficient serum, pooled normal human serum and in selected sera with high or low concentrations of antibody to group B streptococci. All serotypes were killed by granulocytes after opsonization in normal serum, but serotype IIIR- was comparatively resistant. Properdin deficient serum showed no opsonic activity for type IIIR-. A reduced opsonic capacity of properdin deficient serum for serotypes Ib and IIR+ was demonstrated, whereas the other serotypes were efficiently opsonized. The reduced or absent opsonic activity of properdin deficient serum could be restored by addition of purified properdin. Antibody levels did not appear to be limiting in the assay system. Blocking of C1 activation with MgEGTA in normal serum delayed, but did not abolish opsonization of the various group B streptococcal serotypes, while the opsonic activity in chelated properdin deficient serum was markedly reduced. Taken together, the findings suggest that an intact classical pathway is crucial in group B streptococcal opsonization. However, efficient opsonization of some strains apparently requires that C3 activation on the bacterial surface is amplified through recruitment of the alternative pathway.

Complement Pathway, Alternative↗

Native and activated properdin: interconvertibility and identity of amino- and carboxy-terminal sequences.

The development of a two-step purification procedure of native properdin with good yield has allowed the physical and chemical comparison of native and activated properdin. The two forms of properdin have identical electrophoretic mobility, subunit size, and amino- as well as carboxyl-terminal amino acid sequences. The two forms of properdin can be interconverted by using mild denaturing agents, indicating that the change in biologic activity is conformational. Circular dichroism analysis of properdin reveals a significant variability in the tertiary structure. However, the differences are a result of the method of purification and do not correspond to the biologic activity of the protein, because the spectra of the interconverted forms of properdin do not change. This indicates that the conformational transition that causes biologic activity changes is small, relative to the conformational variations produced by other conditions that do not alter the biologic activity.

Amino Acid Sequence↗

Complement activation in semi-solid medium: Insolubilization of properdin and the third component of complement (C3) in agar gels.

Although the role of properdin in the alternative pathway of complement activation remains unclear, evidence has recently been obtained for the formation of complexes between properdin and other components, including C3. In this study such complexes have apparently been directly visualized. When normal human serum and properdin were allowed to diffuse toward each other in agar gel for 16 hr, a line of precipitation could be seen when stained with Coomassie brilliant blue. The reaction occured at pH 8.6 in 0.05 M Veronal buffer at room temperature but not under physiologic conditions of pH or tonicity. Like the alternative pathway, the reaction was Me++ dependent, occurred with C2- or C5-deficient or hypogammaglobulinemic serum, and did not occur with aged, 52 degrees C-inactivated, C3b inactivator-deficient, or C3-deficient serum. 125I-labeled C3 and properdin but not Factor B were incorporated in the precipitate. Eleven sera containing the C3 nephritic factor failed to produce a precipitate with properdin, but a line of precipitation occurred between seven of these sera and normal serum. This line showed identity with the line occurring between properdin and normal serum. The phenomenon appears to result from formation of insoluble complexes between proteins of the alternative pathway and agar.

Agar↗

Purification of native properdin by reversed affinity chromatography and its activation by proteolytic enzymes.

A highly purified preparation of human properdin (P) has been obtained in a simple two-step procedure utilizing reversed application of the technique of affinity chromatography. The method involved precipitation of properdin from human serum and subsequent passage through an immunoadsorbent column of Sepharose anti-RP globulin which bound the contaminating proteins. The immunochemical properties of the isolated properdin (P) was found to be different from those of activated properdin (P). P was shown to be a 6.1S, beta2 globulin with a mean subunit m.w. of 57,900. P on the other hand was a 5.1S protein with gamma2 mobility and a subunit m.w. of 53,000 daltons. Double diffusion analysis using anti-P revealed a reaction of identity between P and P. However, when the reaction was developed with anti-P, a reaction of partial identity was obtained and the precipitin line of P was seen to spur over the line developed with P. Mild treatment with plasmin or trypsin converted P to P. Unlike P, P was ineffective in triggering the activation of the Properdin System in RP unless trace amounts of zymosan were added. Under these conditions P was found to be converted to P. The results indicate that properdin is present in fresh serum in a precursor form and its activation to P involves a limited proteolytic cleavage of the molecule.

Chromatography, Affinity↗

An alternative mechanism for the properdin system.

Evidence is presented that phenomena ascribed to the properdin system may be explained in terms of classical antibody (Ab) in combination with three of the components of complement (C'), i.e., C'(1), C'(4), and C'(2) respectively. The results suggest that the complex of properdin (P) with zymosan (Z) represents a mixture of Z.Ab, Z.Ab.C'(1, 4), Z.Ab-C'(1, 4, 2), and Z.Ab.C'(1, 4, 2) in a decayed state. The purported preferential reactivity of Z with the third component of C' (C'(3)) is not supported by the present experiments in which Z was reacted with C' in both guinea pig and human sera. Approximately the same number of reactive units of C'(1, 4) and of C'(3) were inactivated by Z, as well as by D. pneumoniae and a washed specific precipitate of bovine albumin-anti-albumin. The latter evidence that small amounts of antigen-antibody complex fix significant amounts of C'(3) stands in contrast with the classical concept that C'(3) is not fixed in ordinary complement fixation reaction. The observed reactivity of C'(3) is explained on the basis of the present use of essentially undiluted serum as a source of C'(3) and of 37 degrees as the temperature for fixation. Ancillary data indicate that purified properdin contains Ab. In the presence of a chelating agent and at 0 degrees properdin agglutinated Z granules. Measurements of nitrogen (N) uptake by Z suggest that 0.25 microg. N were contributed by solutions stated to contain 1 unit of properdin. The broad spectrum of reactivity or cross-reactivity of the Ab in normal serum is likely due to the wide distribution in nature of closely related polysaccharides. Further immunochemical studies are necessary to establish definitively the origin and mode of action in "natural resistance" of antibodies reactive with these polysaccharides.

Animals↗

Molecular cloning of the cDNA coding for properdin, a positive regulator of the alternative pathway of human complement.

Northern blot analysis indicated that the mRNA for human properdin is approximately 1.5 kb long and that its level in U-937 cells is increased by pretreating the cells with phorbol 12-myristate 13-acetate (PMA). Using a human genomic probe clones coding for human properdin were isolated from a lambda gt10 cDNA library derived from PMA-treated U-937 cells. The sequence of the 1474-bp cDNA insert of the longest clone revealed an open reading fram of 1326 bp coding for the entire 442 amino acids of the mature form of human properdin and 67 bp coding for 22 amino acids of typical, but incomplete leader sequence. Polymerase chain reaction "RACE" experiments identified the start site ATG and revealed the complete, 27-amino acid-long, leader peptide sequence. Within the 81-bp 3' non-translated extension a polyadenylation signal was identified 41 bp downstream from the stop codon, TAA, and 12 bp upstream of a 19 nucleotide long poly(A) tail. The amino acid sequence of human properdin is clearly divided into three distinct regions: a 49 residue-long N-terminal region, a 32 residue-long C-terminal region and a middle region, covering residues 50 to 411, composed of six tandemly repeated thrombospondin repeat (TSR) motifs of the type first described in the adhesive glycoprotein thrombospondin and also known to be present in the C6, C7, C8 alpha, C8 beta and C9 terminal components of complement. Human and mouse properdin sequences show a high (approximately 76%) degree of identity with almost complete conservation of the relatively large number of Cys (44) and Trp (20) residues.

Amino Acid Sequence↗

Sequence-based analysis of properdin deficiency: identification of point mutations in two phenotypic forms of an X-linked immunodeficiency.

Properdin deficiency is an inherited X-linked disorder causing increased susceptibility to meningococcal disease. Here, underlying genetic defects in the properdin gene were identified for the first time. Samples from individuals with type I deficiency, defined as complete absence of properdin in serum, and individuals with type II deficiency, characterized by low concentrations of properdin in serum, were analyzed by direct chromosome sequencing of overlapping PCR products. The complete gene, including 10 exons and 9 introns, covering 6460 bases of the region Xp11, was investigated by direct solid-phase sequencing. In the related individuals with type I deficiency a C to T mutation in exon 5 was identified, which gives rise to a stop codon TGA and thus a truncated gene product. In addition, point mutations were found in 4 introns and a silent mutation in exon 10. In the properdin gene from related individuals with type II deficiency two point mutations were found, one in intron 3 and one in exon 4. The latter mutation yields a substitution of arginine to tryptophan, which may affect folding, secretion, and/or turnover of the protein. The genetic and biochemical implications of these mutations are discussed.

Base Sequence↗

Immune response to tetravalent meningococcal vaccine: opsonic and bactericidal functions of normal and properdin deficient sera.

Neisseria meningitidis serogroup W-135 appears to be a fairly common cause of infection associated with properdin deficiency or dysfunction, and anticapsular antibodies might be protective in these patients. For this reason, bactericidal and opsonophagocytic activities for serogroup W-135 were investigated before and four weeks after vaccination of two properdin-deficient adults with tetravalent meningococcal vaccine. In addition, the response of IgM, IgG and IgA class antibodies to the serogroups A, C, Y and W-135 was determined by ELISA. There was no evidence of poor antibody responses in the properdin-deficient persons. Vaccination promoted classical pathway-mediated killing in serum and opsonization of serogroup W-135 to the same extent as that seen in vaccinated controls. The increase of alternative pathway-mediated killing in the properdin-deficient sera was moderate, but vaccination clearly enhanced alternative pathway-mediated opsonophagocytosis in the sera. It was also shown that vaccination markedly reduced the requirement for properdin in alternative pathway-mediated killing of the meningococci.

Adult↗

A simple method for isolation of human properdin by affinity chromatography.

Human properdin was prepared from the zymosan eluate or euglobulin fraction of serum by immunoadsorbent column chromatography. An immunoadsorbent column containing antibody to human serum was employed to remove serum proteins other than properdin from zymosan eluates. Immunoadsorbent with antibody to properdin was used for direct isolation of properdin from the euglobulin fraction. Properdin isolated by these methods showed satisfactory purity with high activity. No immunochemical differences between the two types of preparation were found.

Animals↗

A radial hemolysis method in agarose for the functional assay of properdin.

A simple one-step radial hemolytic assay for properdin has been devised. In this assay, the test material is introduced into a well in an agarose plate containing optimal concentrations of normal human serum immunochemically depleted of properdin (RP), EGTA, magnesium ions and unsensitized guinea pig erythrocytes. Following radial diffusion, the area of the hemolytic zones resulting from the activation of the alternative complement pathway and bystander lysis of guinea pig erythrocytes was directly proportional to the concentration of properdin in the test material. The assay is specific reproducible and sensitive and the correlation with the radioimmunoassay for properdin is very good. The assay has been used to measure properdin activity in animal sera.

Animals↗

Expression and characterisation of the thrombospondin type I repeats of human properdin.

Properdin, an upregulator of the alternative complement pathway, is central to deposition of the activated complement fragment C3b on the surfaces of the pathogens, which it achieves by preventing the dissociation of the Bb catalytic subunit from the inherently labile C3bBb complexes. It is also known to bind sulphated glycoconjugates, such as sulphatides. Properdin has an unusual structure formed by oligomerisation of a rod-like monomer into cyclic dimers, trimers and tetramers. The monomer (approximately 53 kDa) contains an N-terminal region of no known homology, followed by six non-identical repeats of 60 amino acids (based on exon/intron boundaries), called 'thrombospondin type I repeats' or TSR modules. We have expressed and purified the N-terminal region and each of the individual TSR repeats in Escherichia coli. Although the individual recombinant TSRs, after a denaturation-renaturation cycle, appeared to be correctly folded modules, as judged by the one-dimensional (1D)- and 2D-nuclear magnetic resonance spectra of TSR3, they did not show binding to either C3b or sulphatide. Polyclonal antibodies were raised against each TSR and were found to be module-specific. The anti-TSR5 polyclonal antibody was found to inhibit binding of native human properdin to solid-phase C3b, or sulphatides. It could also block properdin-dependent haemolysis of rabbit erythrocytes. These results are consistent with the view that the TSR5 contains the major site in properdin which is involved in both C3b and sulphatide binding. It also suggests that a co-operative intramolecular interaction between TSRs, as found in the native molecule, is required for TSR5 to bind either C3b or sulphatides.

Amino Acid Sequence↗