title: Levels of complement in sera from inactive SLE patients, although decreased, do not influence in vitro uptake of apoptotic cells.
abstract: BACKGROUND
  Accumulation of apoptotic cells is considered relevant in the pathogenesis of systemic lupus erythematosus (SLE). Complement factors facilitate the clearance of apoptotic cells and, when decreased, might result in an increased amount of apoptotic cells found in SLE patients.
  
  
  OBJECTIVE
  To determine the influence of complement profiles from inactive SLE patients on the in vitro phagocytosis of apoptotic cells.
  
  
  METHODS
  Consecutive SLE patients (n=98) with inactive disease (SLEDAI < or =4) and 20 healthy controls (HC) were included. Levels of CH50, C3, C4, C1q, and C1r were measured. Human peripheral blood monocytes were isolated from healthy controls and cultured for 7 days to obtain monocyte-derived macrophages (MDM). Jurkat cells were irradiated with UVB to induce apoptosis. Phagocytosis was tested by incubation of MDM with apoptotic cells in the presence of serum and quantified as phagocytosis index (number of Jurkat cells internalized by 100 macrophages). Serum from 20 patients with CH50<65%, 20 patients with CH50 > or =65%, and 20 HC were used in this assay.
  
  
  RESULTS
  All HC and 37% of patients had normal complement levels. CH50 level was decreased in 21% of patients, C3 in 52%, C4 in 29%, C1q in 2% and C1r in 44% of patients. Between patients and HC, differences in level of CH50, C3 and C4 were statistically significant. No difference in phagocytosis index between HC and patients, irrespective of their CH50 level, was detected. No correlation was found between the respective complement levels and phagocytosis index.
  
  
  CONCLUSIONS
  In most SLE patients with inactive disease, levels of one or more complement components are decreased. However, decreased levels of complement do not result in a significantly reduced in vitro uptake of apoptotic Jurkat cells by MDM.
authors.affiliation: Department of Internal Medicine, Division of Clinical Immunology, University Hospital, PO Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: Grevink
authors.forename: G
authors.initials: G
authors.lastname: Horst
authors.forename: P C
authors.initials: PC
authors.lastname: Limburg
authors.forename: C G M
authors.initials: CG
authors.lastname: Kallenberg
authors.forename: M
authors.initials: M
authors.lastname: Bijl
mesh_terms: D000328:Adult; D017209:Apoptosis; D003167:Complement Activation; D003165:Complement System Proteins / Q000032:analysis*; D005260:Female; D006801:Humans; D019169:Jurkat Cells; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000473:pathology; D008264:Macrophages / Q000378:metabolism* / Q000473:pathology; D008297:Male; D010587:Phagocytosis
chemical_list: D003165:Complement System Proteins