Prostaglandin and complement interaction in clinical acute respiratory failure.
This study investigated the interaction of plasma levels of circulating prostaglandins and activated complement in clinical acute respiratory failure (ARDS). Fifty patients at risk for ARDS were followed up for up to ten days. Arterial blood gases and plasma levels of complement components C3a and C5a, thromboxane B2 (TxB), and prostaglandin 6-keto-F1 alpha (PGI) and granulocyte aggregation (GA) were measured daily. Seventeen patients (34%) developed ARDS, with mortality of 41% vs 23% for patients without ARDS. Compared with patients without ARDS, the ARDS group had significantly increased plasma C3a (1,130 +/- 750 vs 636 +/- 368 ng/mL) and granulocyte aggregation (48 +/- 10 vs 17 +/- 4 percentage of the maximum light transmission [% max T]). Plasma C5a, TxB, or PGI did not change significantly with or without ARDS. No measured variable was significantly associated with mortality. Regression analysis revealed significant correlations between GA, TxB, PGI, and arterial oxygenation. Plasma C3a and GA are increased in ARDS, suggesting systemic complement activation. A complex series of interactions between the prostaglandins, complement, and GA appears to be involved in ARDS.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002449:Cell Aggregation; D003167:Complement Activation; D003176:Complement C3 / Q000032:analysis*; D015926:Complement C3a; D003182:Complement C5 / Q000032:analysis*; D015936:Complement C5a; D011464:Epoprostenol / Q000097:blood*; D005260:Female; D006098:Granulocytes / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D011863:Radioimmunoassay; D012044:Regression Analysis; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000276:immunology; D013928:Thromboxane A2 / Q000097:blood*
D003176:Complement C3; D003182:Complement C5; D013928:Thromboxane A2; D015926:Complement C3a; D015936:Complement C5a; D011464:Epoprostenol; D010100:Oxygen