Terminal complement complex in septic shock with capillary leakage: marker of complement activation?
OBJECTIVE
The aim of this study was to evaluate the value of terminal complement complex (C5b-9) plasma levels as a marker for complement activation in septic shock with concomitant capillary leak syndrome.


METHODS
In a prospective animal study 10 fasted, anaesthetized, mechanically ventilated and multi-catheterized pigs (20.6 +/- 1.3 kg) were investigated over a period of 8 h. Sepsis was induced by faecal peritonitis (1 g kg(-1) body weight faeces, n = 5) and compared to controls (n = 5). The animals received 6% hydroxyethyl starch 200/0.5 to maintain a central venous pressure of 12 mmHg. To quantify capillary leak syndrome, albumin escape rate was measured using 99mTc-labelled human serum albumin. Plasma levels of terminal complement complex were measured in a double antibody immunoassay (neoepitope-specific MoAb aE 11 as catching antibody). Immunohistological studies of renal specimens were performed to detect terminal complement complex deposition.


RESULTS
Albumen escape rate increased in septic animals (+ 52%) compared to controls (+ 3%, P < 0.05). Plasma levels of terminal complement complex decreased during the study period in both groups. In septic animals this finding was accompanied by a significant deposition of terminal complement complex in renal specimens (P < 0.05).


CONCLUSIONS
We found an activation of the complement system proven by marked deposition of terminal complement complex in renal specimen, while its plasma levels decreased during the study period in septic and control animals. These results suggest that in septic shock with capillary leak syndrome plasma level of terminal complement complex may not be a reliable marker of complement activation.
Schuerholz
T
T
Friedrich Schiller University, Department of Anaesthesiology and Intensive Care, Jena, Germany. tobias.schuerholz@med.uni-jena.de
Leuwer
M
M
Cobas-Meyer
M
M
Vangerow
B
B
Kube
F
F
Kirschfink
M
M
Marx
G
G
D000818:Animals; D015415:Biomarkers; D001798:Blood Proteins / Q000378:metabolism; D019559:Capillary Leak Syndrome / Q000503:physiopathology*; D003167:Complement Activation / Q000502:physiology*; D003182:Complement C5 / Q000378:metabolism*; D015938:Complement Membrane Attack Complex / Q000378:metabolism*; D004911:Erythrocyte Volume / Q000502:physiology; D005260:Female; D006400:Hematocrit; D006439:Hemodynamics; D007150:Immunohistochemistry; D007668:Kidney / Q000473:pathology; D007813:Laparotomy; D008297:Male; D010100:Oxygen / Q000097:blood; D010953:Plasma Volume / Q000502:physiology; D012772:Shock, Septic / Q000378:metabolism* / Q000473:pathology; D013552:Swine
D015415:Biomarkers; D001798:Blood Proteins; D003182:Complement C5; D015938:Complement Membrane Attack Complex; D010100:Oxygen