Langlois P F, Gawryl M S
Department of Immunology/Microbiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612.
Clin Immunol Immunopathol. 1988 May;47(2):152-63. doi: 10.1016/0090-1229(88)90068-2.
We have previously reported that plasma concentrations of the terminal complement (C) complex (TCC), C5b-9, increased significantly 2 days prior to onset of adult respiratory distress syndrome (ARDS) and also 1 day preceding its resolution. To determine the pathway of complement activation that preceded development and resolution of this acute inflammatory lung injury in septic patients, we quantified the C1rC1s-C1 inhibitor complex and the C3bP complex, which are generated following activation of classical and alternative complement pathways, respectively. Two days prior to diagnosis of ARDS, the plasma C1rC1s-C1 inhibitor complex and C3bP complex levels increased 22 and 14%, respectively. Furthermore, significant correlations were identified between concentrations of the TCC and C1rC1s-C1 inhibitor complex (r = 0.73, P = 0.003) and also with the levels of the TCC and C3bP complex (r = 0.81, P = 0.002) before onset of ARDS. Equally of interest, the C1rC1s-C1 inhibitor complex and C3bP complex concentrations increased 68 and 35%, respectively, 1 day before resolution of ARDS. Similarly, significant elevations of TCC concentrations preceding resolution of ARDS correlated with C1rC1s-C1 inhibitor complex (r = 0.66, P = 0.02) and also with C3bP complex (r = 0.72, P = 0.002) levels. Our results indicate that both the classical and alternative complement pathways are activated prior to onset of ARDS and also before its resolution in septic patients.
我们之前报道过，终末补体（C）复合物（TCC），即C5b-9的血浆浓度在成人呼吸窘迫综合征（ARDS）发病前2天显著升高，且在其病情缓解前1天也显著升高。为了确定脓毒症患者急性炎症性肺损伤发生和缓解之前补体激活的途径，我们对C1rC1s-C1抑制剂复合物和C3bP复合物进行了定量，它们分别是在经典和替代补体途径激活后产生的。在ARDS诊断前2天，血浆C1rC1s-C1抑制剂复合物和C3bP复合物水平分别升高了22%和14%。此外，在ARDS发病前，TCC浓度与C1rC1s-C1抑制剂复合物浓度之间存在显著相关性（r = 0.73，P = 0.003），TCC浓度与C3bP复合物水平之间也存在显著相关性（r = 0.81，P = 0.002）。同样有趣的是，在ARDS缓解前1天，C1rC1s-C1抑制剂复合物和C3bP复合物浓度分别升高了68%和35%。类似地，ARDS缓解前TCC浓度的显著升高与C1rC1s-C1抑制剂复合物（r = 0.66，P = 0.02）以及C3bP复合物（r = 0.72，P = 0.002）水平相关。我们的结果表明，在脓毒症患者中，经典和替代补体途径在ARDS发病前以及病情缓解前均被激活。
