Studies of complement activation in ARDS patients treated by long-term extracorporeal CO2 removal.
To investigate the role of complement activation in the adult respiratory distress syndrome (ARDS) and in the complications of extracorporeal circulation (ECC), several parameters (CH50, C3 split products, C3a, C5a, PMN aggregating activity, carboxypeptidase activity) of the complement profiles of 23 ARDS patients were measured. Twenty patients were treated by long-term extracorporeal support. Before connection to ECC, marked leukocytosis (18,250 +/- 5,950) and significantly high plasma C3a levels (p less than 0.005) were observed. After connection, C3a levels increased further, up to values eight times higher than the basal ones. The WBC count transiently decreased to 41% of prebypass levels after 15 minutes of ECC. At the same time C3 split products appeared and PMN aggregating activity was shown in 52% of the patients. C5a levels remained normal during bypass, even in two samples in which PMN aggregating activity was detected. Later decreases in CH50 titers (p less than 0.001) and carboxypeptidase activity (p less than 0.005) were observed. Complement activation was no longer evident after the 24th hour of bypass. We conclude that there is a low-degree complement activation in ARDS, and ECC is a further strong stimulus for complement activation. This phenomenon appears, however, to be self-limited.
D000293:Adolescent; D000328:Adult; D002245:Carbon Dioxide / Q000097:blood; D002268:Carboxypeptidases / Q000097:blood; D002648:Child; D003167:Complement Activation; D003176:Complement C3 / Q000032:analysis; D015926:Complement C3a; D003182:Complement C5 / Q000032:analysis; D015936:Complement C5a; D003165:Complement System Proteins / Q000032:analysis; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000276:immunology / Q000628:therapy*; D013997:Time Factors
D003176:Complement C3; D003182:Complement C5; D002245:Carbon Dioxide; D015926:Complement C3a; D015936:Complement C5a; D003165:Complement System Proteins; D002268:Carboxypeptidases