Complement activation in diabetic ketoacidosis and its treatment.
Recent studies support the presence of an inflammatory response during the treatment of diabetic ketoacidosis (DKA). The objectives of this study were to monitor the complement activation products C3a, C4a, Bb, and C5b-9 prior to, during, and after correction of DKA. All patients had increased levels of C3a at 6-8 h and 24 h (P<0.05). C4a was increased in only one patient. Bb showed an upward trend at 6-8 h, and was significantly elevated at 24 h (P<0.05); sC5b-9 was elevated in all patients prior to treatment or in the first 6-8 h of treatment. Results indicate that the alternative pathway may be the primary pathway of activation. These results extend the observation that both DKA and its treatment produce varying degrees of immunologic stress during the time when acute complications are most likely to occur.
Jerath
Rita S
RS
Section of Rheumatology, Department of Pediatrics, Medical College of Georgia, Augusta, GA 30912, USA.
Burek
C Lynne
CL
Hoffman
William H
WH
Passmore
Gregory G
GG
D000293:Adolescent; D003167:Complement Activation / Q000276:immunology*; D051561:Complement C3 Convertase, Alternative Pathway; D015926:Complement C3a / Q000378:metabolism; D003179:Complement C3b; D015934:Complement C4a / Q000378:metabolism; D015938:Complement Membrane Attack Complex / Q000378:metabolism; D003165:Complement System Proteins / Q000276:immunology*; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000276:immunology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000097:blood
D015938:Complement Membrane Attack Complex; D010446:Peptide Fragments; D015926:Complement C3a; D003179:Complement C3b; D015934:Complement C4a; D003165:Complement System Proteins; D051561:Complement C3 Convertase, Alternative Pathway