title: Complement activation during storage of blood under normal blood bank conditions. Effects of proteinase inhibitors and leukocyte depletion.
abstract: During storage of CPD-A1 preserved whole blood factors of the complement cascade become activated, as evidenced by a rapid increase in the concentrations of C3a-desArg and C4a-desArg. After 10 to 14 days of whole blood storage, the elevations of C3a and C4a levels were highly significant. This increase was paralleled by an increase in the concentration of the lysosomal proteinase elastase from polymorphonuclear (PMN) granulocytes. By contrast, the concentration of the C3 activator complex C4b2b remained unchanged even after 3 weeks of storage. The supplementation of the anticoagulant CPD-A1 with the polyvalent-proteinase-inhibitor aprotinin and the specific elastase-inhibitor eglin C failed to inhibit complement activation, whereas leukocyte depletion could partially abolish the increase of the concentration of C4a, but had no effect on C3a concentrations. These observations support the notion that cleavage of C4 during storage of whole blood is partially leukocyte dependent, whereas the activation of C3 is possibly caused by the activation of the alternate pathway of the complement system by contact of plasma with plastic surfaces.
authors.affiliation: Department of Medicine III; Klinikum Grosshadern, University of Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schleuning
authors.forename: M
authors.initials: M
authors.lastname: Schmid-Haslbeck
authors.forename: H
authors.initials: H
authors.lastname: Utz
authors.forename: M
authors.initials: M
authors.lastname: Jochum
authors.forename: M
authors.initials: M
authors.lastname: Heim
authors.forename: W
authors.initials: W
authors.lastname: Mempel
authors.forename: W
authors.initials: W
authors.lastname: Wilmanns
mesh_terms: D007611:Aprotinin / Q000494:pharmacology; D001771:Blood Banks; D001793:Blood Preservation; D002469:Cell Separation; D003167:Complement Activation / Q000187:drug effects*; D015926:Complement C3a / Q000378:metabolism; D015934:Complement C4a / Q000378:metabolism; D006801:Humans; D007962:Leukocytes / Q000502:physiology*; D009504:Neutrophils / Q000201:enzymology; D010196:Pancreatic Elastase / Q000097:blood; D011480:Protease Inhibitors / Q000494:pharmacology*; D011506:Proteins; D015842:Serine Proteinase Inhibitors / Q000494:pharmacology; D015843:Serpins
chemical_list: D011480:Protease Inhibitors; D011506:Proteins; D015842:Serine Proteinase Inhibitors; D015843:Serpins; C044541:complement C3a, des-Arg-(77)-; C051066:complement C4a, des-Arg; C028656:eglin proteinase inhibitors; D015926:Complement C3a; D015934:Complement C4a; D007611:Aprotinin; D010196:Pancreatic Elastase