Chronological changes in the complement system in sepsis.
The time courses of serum complement levels and the severity of sepsis were compared in two groups of septic patients, one in which the patients survived (surviving group) and one in which they did not (nonsurviving group). The components of the complement system, namely, C3a, C4a, C5a, CH50, C3, C4, and C5, were measured at several points in time after the diagnosis of sepsis had been established. A 2-antibody radioimmunoassay was used to measure C3a, C4a, and C5a; the latex agglutination test was used to measure C3 and C4; nephelometry was used to measure C5; and Meyer's 50% hemolysis method was used to measure CH50. Following the diagnosis of sepsis, the levels of CH50, C3, and C4 were significantly lower in the nonsurviving than the surviving group, while the levels of C3a and C4a were significantly higher in the nonsurviving than the surviving group. The C5a levels were significantly higher in the nonsurviving than the surviving group, although no significant intergroup differences were subsequently noted. These results suggest that the serum levels of C3a, C4a, C5a, CH50, C3, and C4 could serve as indices of the severity of sepsis. Thus, monitoring the complement system may be useful for predicting the outcome of patients with sepsis.
Nakae
H
H
Critical Care and Emergency Center, Department of Bacteriology, Iwate Medical College, Iwate, Japan.
Endo
S
S
Inada
K
K
Yoshida
M
M
D000328:Adult; D000368:Aged; D002056:Burns / Q000276:immunology / Q000401:mortality; D015926:Complement C3a / Q000032:analysis; D015934:Complement C4a / Q000032:analysis; D015936:Complement C5a / Q000032:analysis; D015941:Complement Hemolytic Activity Assay; D003165:Complement System Proteins / Q000032:analysis*; D004211:Disseminated Intravascular Coagulation / Q000276:immunology / Q000401:mortality; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000276:immunology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000276:immunology / Q000401:mortality; D009104:Multiple Trauma / Q000276:immunology / Q000401:mortality; D011014:Pneumonia / Q000276:immunology / Q000401:mortality; D011041:Poisoning / Q000276:immunology / Q000401:mortality; D011379:Prognosis; D018805:Sepsis / Q000276:immunology* / Q000401:mortality; D012772:Shock, Septic / Q000276:immunology* / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors
D015926:Complement C3a; D015934:Complement C4a; D015936:Complement C5a; D003165:Complement System Proteins