HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Complement activation and polymorphonuclear neutrophil leukocyte elastase in sepsis. Correlation with severity of disease.

Abstract
Complement activation is necessary for an adequate immune and inflammatory response to infections. Activation releases anaphylatoxins that cause vasodilation, increase vascular permeability, and trigger release of polymorphonuclear neutrophil leukocyte (PMN) lysosomal enzyme and oxygen radicals. Under normal circumstances, an orderly progression of such events has a beneficial antimicrobial effect. The same mechanism, however, when uncontrolled, may damage host tissues. To provide information about the clinical importance of such events in sepsis, different complement parameters (C3, C4, and the desarginated forms of C3a [C3a(des)-Arg] and C5a [C5a(des)-Arg]), PMN elastase, and malondialdehyde (a by-product of membrane peroxidation by oxygen radicals) were measured daily in 26 septic patients and correlated with two objectively assessed and previously validated severity scores (acute physiology and chronic health evaluation [APACHE II] and Sepsis Severity Score [SSS]). Nonsurvivors (n = 12) had significantly greater and longer lasting complement activation than that in survivors, as reflected by higher levels of catabolic peptides (C3a(des)-Arg) and lower levels of native proteins (C3 and C4). C3a(des)-Arg, C3, C4, and the C3a(des)-Arg-C3 ratio were correlated with Sepsis Severity Scores. Polymorphonuclear neutrophil leukocyte elastase levels were higher in nonsurvivors and were correlated with C3a(des)-Arg and the C3a(des)-Arg-C3 ratio. Malondialdehyde levels were significantly higher in all patients than in controls, without, however, any relationship to severity of disease or clinical outcome. Since the higher and more persistent the complement activation and polymorphonuclear neutrophil leukocyte stimulation, the worse the patient's prognosis, we conclude that these mechanisms may be important in the clinical development of sepsis.
AuthorsM Gardinali, P Padalino, S Vesconi, A Calcagno, S Ciappellano, L Conciato, O Chiara, A Agostoni, A Nespoli
JournalArchives of surgery (Chicago, Ill. : 1960) (Arch Surg) Vol. 127 Issue 10 Pg. 1219-24 (Oct 1992) ISSN: 0004-0010 [Print] United States
PMID1417490 (Publication Type: Journal Article)
Chemical References
  • Anaphylatoxins
  • Complement C3
  • Complement C4
  • Complement C5a, des-Arginine
  • alpha 1-Antitrypsin
  • complement C3a, des-Arg-(77)-
  • Malondialdehyde
  • Complement C3a
  • Pancreatic Elastase
  • Leukocyte Elastase
Topics
  • Adult
  • Aged
  • Anaphylatoxins (analysis)
  • Bacterial Infections (blood, enzymology, immunology)
  • Cell Degranulation (immunology)
  • Cell Membrane (ultrastructure)
  • Complement Activation (physiology)
  • Complement C3 (analysis)
  • Complement C3a (analogs & derivatives, analysis)
  • Complement C4 (analysis)
  • Complement C5a, des-Arginine (analysis)
  • Female
  • Humans
  • Leukocyte Elastase
  • Male
  • Malondialdehyde (analysis, blood)
  • Middle Aged
  • Multiple Organ Failure (immunology)
  • Neutrophils (enzymology, pathology)
  • Pancreatic Elastase (analysis, antagonists & inhibitors, blood)
  • Severity of Illness Index
  • Survival Rate
  • alpha 1-Antitrypsin (analysis)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: