title: Detection of activated complement complex C5b-9 and complement receptor C5a in skin biopsies of patients with systemic sclerosis (scleroderma).
abstract: OBJECTIVE
  Upregulated matrix synthesis is a hallmark of systemic sclerosis (SSc). There are indications that growth factors such as platelet derived growth factor (PDGF) are involved in proliferative pathways in SSc lesions. As activated complement releases PDGF from endothelial cells, we searched for activated complement and the complement receptor for C5a (C5aR) in skin biopsies of patients with SSc.
  
  
  METHODS
  Snap frozen sections of 8 patients with early SSc and 5 patients with longterm SSc were examined. Using monoclonal antibodies against activated complement complex C5b-9 and the C5aR, skin biopsies derived from both clinically involved and non-involved skin were examined by APAAP immunohistochemistry.
  
  
  RESULTS
  A pattern of activated complement C5b-9 and the CSaR could be detected in SSc microvasculature. Eleven of the 13 patients (7/8 patients with early SSc) showed positive staining for C5b-9. The CSaR was detected in 6 of the 8 patients with early SSc. In 3 patients with longterm disease, C5aR expression could also be detected in non-involved skin.
  
  
  CONCLUSIONS
  Activated complement and complement receptors could be detected in early and late stages of SSc skin lesions. The presence of complement receptors in non-involved skin may indicate preclinical activation of pathways resulting in growth factor dependent matrix synthesis.
authors.affiliation: WHO Collaborating Center for Molecular Biology and Novel Therapeutic Strategies for Rheumatic Diseases, Department of Rheumatology, University of Zürich, Switzerland. ruzsph@ruz.unizh.ch
authors.forename: H
authors.initials: H
authors.lastname: Sprott
authors.forename: U
authors.initials: U
authors.lastname: Müller-Ladner
authors.forename: O
authors.initials: O
authors.lastname: Distler
authors.forename: R E
authors.initials: RE
authors.lastname: Gay
authors.forename: S R
authors.initials: SR
authors.lastname: Barnum
authors.forename: M
authors.initials: M
authors.lastname: Landthaler
authors.forename: J
authors.initials: J
authors.lastname: Schölmerich
authors.forename: B
authors.initials: B
authors.lastname: Lang
authors.forename: S
authors.initials: S
authors.lastname: Gay
mesh_terms: D015703:Antigens, CD / Q000276:immunology / Q000378:metabolism*; D001706:Biopsy; D015936:Complement C5a / Q000276:immunology / Q000378:metabolism*; D015938:Complement Membrane Attack Complex / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D044087:Receptor, Anaphylatoxin C5a; D011951:Receptors, Complement / Q000276:immunology / Q000378:metabolism*; D012595:Scleroderma, Systemic / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D012867:Skin / Q000276:immunology / Q000378:metabolism* / Q000473:pathology
chemical_list: D015703:Antigens, CD; D015938:Complement Membrane Attack Complex; D044087:Receptor, Anaphylatoxin C5a; D011951:Receptors, Complement; D015936:Complement C5a