title: Complement activation in patients with sepsis is in part mediated by C-reactive protein.
abstract: The involvement of C-reactive protein (CRP) in the activation of complement in patients with sepsis was investigated. In 104 patients with infections of varying severity, circulating levels of CRP-complement complexes, which are specific indicators for CRP-mediated complement activation, were assessed. Complement-CRP complexes were increased in almost all patients and correlated significantly with levels of C3a (r = .59; P < .001) and C-reactive protein (r = .76; P < .001). In addition, they correlated with levels of secretory phospholipase A2 (r = .59; P < .001). Levels of complement-CRP complexes in patients with a pneumococcal type of infection were similar to those in patients with other types of infections. Complement-CRP complexes were significantly higher in patients with shock (P = .01) and in patients who died (P = .03). These results demonstrate that part of the complement activation in patients with sepsis is independent from a direct interaction with microorganisms but rather results from an endogenous mechanism involving CRP.
authors.affiliation: Central Laboratory of The Netherlands Red Cross Blood Transfusion Service, Academic Medical Centre, University of Amsterdam.
authors.forename: G J
authors.initials: GJ
authors.lastname: Wolbink
authors.forename: A W
authors.initials: AW
authors.lastname: Bossink
authors.forename: A B
authors.initials: AB
authors.lastname: Groeneveld
authors.forename: M C
authors.initials: MC
authors.lastname: de Groot
authors.forename: L G
authors.initials: LG
authors.lastname: Thijs
authors.forename: C E
authors.initials: CE
authors.lastname: Hack
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis / Q000276:immunology* / Q000378:metabolism; D003167:Complement Activation; D015926:Complement C3a / Q000032:analysis / Q000276:immunology; D003165:Complement System Proteins / Q000276:immunology / Q000378:metabolism; D006801:Humans; D010741:Phospholipases A / Q000032:analysis / Q000378:metabolism; D054467:Phospholipases A2; D011008:Pneumococcal Infections / Q000276:immunology; D018805:Sepsis / Q000097:blood / Q000276:immunology* / Q000401:mortality; D012772:Shock, Septic / Q000276:immunology
chemical_list: D015926:Complement C3a; D003165:Complement System Proteins; D002097:C-Reactive Protein; D010741:Phospholipases A; D054467:Phospholipases A2