Activation and inhibition of Hageman factor-dependent pathways and the complement system in uncomplicated bacteremia or bacterial shock.
Levels of components of the contact activation, coagulation, and complement systems and their main inhibitors were measured in 45 critically ill patients during 61 episodes of uncomplicated bacteremia or bacterial shock. Levels of Hageman factor (factor XII), prekallikrein, high-molecular-weight kininogen, factor XI, factor VII, total hemolytic complement, alternative pathway activity, and C3 were within the normal range during uncomplicated bacteremia (n = 29), but during fatal bacterial shock (n = 13) a significant decrease by 40%-50% was observed in all measurements. During nonfatal bacterial shock (n = 19) a moderate decrease was observed in most of these measurements. The capacity of plasma to inactivate kallikrein was significantly higher during bacteremia than during bacterial shock because of a significant increase in the level of C1 esterase inhibitor. Levels of antithrombin III and alpha 2-macroglobulin were below normal in all groups. Thus increased inhibition of the contact activation and complement systems is beneficial during bacteremia.
Kalter
E S
ES
Daha
M R
MR
ten Cate
J W
JW
Verhoef
J
J
Bouma
B N
BN
D000805:Angiotensin III / Q000097:blood; D001777:Blood Coagulation; D003167:Complement Activation; D003174:Complement C1 Inactivator Proteins / Q000097:blood; D003176:Complement C3 / Q000032:analysis; D005167:Factor VII / Q000032:analysis; D005172:Factor XI / Q000032:analysis; D005174:Factor XII / Q000502:physiology*; D006801:Humans; D007704:Kininogens / Q000097:blood; D011288:Prekallikrein / Q000032:analysis; D018805:Sepsis / Q000097:blood* / Q000276:immunology; D012772:Shock, Septic / Q000097:blood* / Q000276:immunology; D000511:alpha-Macroglobulins / Q000032:analysis
D003174:Complement C1 Inactivator Proteins; D003176:Complement C3; D007704:Kininogens; D000511:alpha-Macroglobulins; D000805:Angiotensin III; D005167:Factor VII; D005174:Factor XII; D005172:Factor XI; D011288:Prekallikrein