Young G A, Kendall S, Brownjohn A M
Renal Research Unit, General Infirmary, Leeds, UK.
Nephrol Dial Transplant. 1993;8(12):1372-5.
Complement activation was monitored in 20 CAPD patients and 20 normal individuals using markers of the alternative (Bb fragment), classical (C4d fragment), common (iC3b) and terminal pathways (SC5b-9, the soluble form of the membrane attack complex, MAC), together with C3, C4 and factor B. CAPD plasma SC5b-9 was higher than normal although this was not due to increased complement activation in the plasma. The calculated cleavage for C3, C4 and factor B to iC3b, C4d and Bb respectively, due to spontaneous activation, was similar in both groups. C3, C4 and factor B in dialysate were less than 1% of plasma concentration, consistent with vascular leakage, whereas iC3b, Bb and SC5b-9 were at higher concentrations, suggesting generation in the peritoneum by the alternative pathway. 2.4% C4d is consistent with leakage of this small molecule but may indicate slight classical activation. It is concluded that complement activation occurs in the peritoneum during CAPD. MAC and the anaphylatoxins which are also generated may contribute to an increased risk of infection and other inflammatory complications.
使用替代途径（Bb片段）、经典途径（C4d片段）、共同途径（iC3b）和终末途径（SC5b-9，膜攻击复合物的可溶性形式，MAC）的标志物以及C3、C4和B因子，对20例持续性非卧床腹膜透析（CAPD）患者和20名正常个体的补体激活情况进行了监测。CAPD患者血浆中的SC5b-9高于正常水平，不过这并非由于血浆中补体激活增加所致。两组中因自发激活导致的C3、C4和B因子分别裂解为iC3b、C4d和Bb的计算值相似。透析液中的C3、C4和B因子低于血浆浓度的1%，这与血管渗漏相符，而iC3b、Bb和SC5b-9的浓度较高，提示替代途径在腹膜中产生。2.4%的C4d与这种小分子的渗漏相符，但可能表明存在轻微的经典激活。得出的结论是，在CAPD过程中腹膜会发生补体激活。所产生的MAC和过敏毒素可能会增加感染及其他炎症并发症的风险。
