title: Early complement activation follows eversion carotid endarterectomy and correlates with the time of clamping of the carotid artery.
abstract: BACKGROUND
  Complement activation plays an important role in ischemia/reperfusion (I/R) injury. The objective of the present study was to detect the presence and mechanism of complement activation in patients who underwent carotid endarterectomy (CEA).
  
  
  METHODS
  Complement activation products C1rsC1-inhibitor, C4d, C3a and SC5b-9 and concentrations of C-reactive protein (CRP) were measured in samples serially taken from 16 patients with eversion CEA and 10 with carotid artery stenting (CAS) in the first 24h post-surgery/intervention. MBL2 genotypes were also determined.
  
  
  RESULTS
  In patients with CEA an intense increase in C3a levels were observed immediately after surgery (p<0.001), accompanied by a slight elevation in SC5b-9 levels (p<0.05). C3a levels remained elevated until 4h post-surgery, compared with the baseline values and with CAS patients. Peak C3a levels correlated with the time of carotid clamping (r=0.5921, p=0.02). No significant changes were detected in C1rsC1-inhibitor or C4d levels following CEA, and we found no association between the generation of C3a and MBL2 genotypes or CRP levels. Complement activation was not present in patients with CAS.
  
  
  CONCLUSIONS
  Early complement activation follows CEA and correlates with the time of I/R injury. The lack of C4d generation suggests the role of the alternative and not the lectin pathway in the process.
authors: 3rd Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Kútvölgyi út 4, H-1125Budapest, Hungary.
authors: Gábor
authors: G
authors: Széplaki
authors: Kristóf
authors: K
authors: Hirschberg
authors: Tímea
authors: T
authors: Gombos
authors: Lilian
authors: L
authors: Varga
authors: Zoltán
authors: Z
authors: Prohászka
authors: Edit
authors: E
authors: Dósa
authors: György
authors: G
authors: Acsády
authors: István
authors: I
authors: Karádi
authors: Peter
authors: P
authors: Garred
authors: László
authors: L
authors: Entz
authors: George
authors: G
authors: Füst
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000276:immunology; D002339:Carotid Arteries / Q000276:immunology* / Q000473:pathology*; D003167:Complement Activation / Q000276:immunology*; D015926:Complement C3a / Q000276:immunology; D003250:Constriction; D016894:Endarterectomy, Carotid; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D037601:Mannose-Binding Lectin / Q000276:immunology; D008875:Middle Aged; D015427:Reperfusion Injury / Q000276:immunology; D015607:Stents; D013997:Time Factors
chemical_list: C445619:MBL2 protein, human; D037601:Mannose-Binding Lectin; D015926:Complement C3a; D002097:C-Reactive Protein