Figueroa J, Andreoni J, Densen P
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City.
Immunol Res. 1993;12(3):295-311. doi: 10.1007/BF02918259.
Analysis of complement deficiency states has supported the role of complement in host defense and elucidated diseases associated with defective complement function. Although neisserial infection plays a prominent role in these deficiency states, examination of individuals with late complement component deficiency (LCCD) reveals a particular propensity for recurrent meningococcal disease and provides important clues to the role of complement in neisserial infections. In response to meningococcal disease, LCCD individuals produce significantly greater amounts of antilipooligosaccharide (LOS) antibody which can kill group B meningococcus in a complement-sufficient in vitro system. Further studies of antibody cross-reactivity to other meningococci has led to a clearer understanding of its epitopic specificity. Nevertheless, epidemiologic evidence is consistent with the relative absence of protective immunity in LCCD persons following an episode of infection and supported by quantitation of antibody to capsular polysaccharide. However, compared to anti-LOS antibodies, anticapsular antibodies can offer immune protection to LCCD individuals via complement-dependent opsonophagocytosis--the only form of complement-mediated killing available to these persons. Thus vaccination of LCCD persons with capsular antigens is considered an important means of protecting these high-risk individuals against meningococcal disease.
对补体缺陷状态的分析证实了补体在宿主防御中的作用，并阐明了与补体功能缺陷相关的疾病。虽然奈瑟菌感染在这些缺陷状态中起重要作用，但对晚期补体成分缺陷（LCCD）个体的检查发现其特别容易患复发性脑膜炎球菌病，并为补体在奈瑟菌感染中的作用提供了重要线索。针对脑膜炎球菌病，LCCD个体产生大量抗脂寡糖（LOS）抗体，这些抗体在补体充足的体外系统中可杀死B群脑膜炎球菌。对其他脑膜炎球菌抗体交叉反应性的进一步研究，使人们对其表位特异性有了更清晰的认识。然而，流行病学证据表明，LCCD个体在感染后相对缺乏保护性免疫，这一点也得到了针对荚膜多糖抗体定量的支持。然而，与抗LOS抗体相比，抗荚膜抗体可通过补体依赖的调理吞噬作用为LCCD个体提供免疫保护，这是这些个体唯一可用的补体介导杀伤形式。因此，用荚膜抗原对LCCD个体进行疫苗接种被认为是保护这些高危个体免受脑膜炎球菌病侵害的重要手段。
