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Published on: May 4, 2017
Immunoadsorption therapy and complement activation
1Blood Center of University Hospital, 17 listopadu 833, 708 52 Ostrava-Poruba, Czech Republic. jan.ptak@fnspo.cz
Insights
Immunoadsorption therapy for myasthenia gravis activates the complement system, indicated by C3, C4, CH50, and TCC changes. Long-term treatment may lead to reduced complement activation, suggesting an immunomodulatory effect.
Area of Science:
- Immunology
- Neurology
Background:
- Myasthenia gravis is an autoimmune disorder affecting neuromuscular junctions.
- Immunoadsorption therapy is used to treat myasthenia gravis by removing pathogenic antibodies.
Purpose of the Study:
- To investigate complement activation during immunoadsorption therapy for myasthenia gravis.
- To assess the impact of long-term immunoadsorption on complement system reactivity.
Main Methods:
- Studied complement activation markers (C3, C4, CH50, TCC) in six myasthenia gravis patients undergoing immunoadsorption therapy (Ig-ADSOPAK).
- Analyzed complement levels before and after each procedure over a mean therapy duration of 18.6 months.
Main Results:
- Immunoadsorption caused a decrease in C3 and C4 levels (median 21.19% and 19.68%).
- Statistically significant complement activation was observed, with median TCC accrual of 60.21% and CH50 decrease of 23.24%.
- No clinical signs of complement activation were noted. A decrease in TCC activation was observed with increasing procedures, significant in 3/5 patients.
Conclusions:
- Immunoadsorption therapy for myasthenia gravis transiently activates the complement system.
- Long-term therapy may induce an immunomodulatory effect, leading to reduced complement system reactivity.
- Further studies with larger patient cohorts are needed to confirm these findings.
Abstract:
Complement activation was studied in six patients treated with immunoadsorption columns Ig-ADSOPAK for myasthenia gravis. Mean therapy duration was 18.6 months (range 4-28 months). Prior and after each procedure, concentrations of C3 and C4 were examined, hemolytic activity of complement by a classic pathway (CH50) was determined, as well as terminal complement complex (TCC). After each immunoadsorption procedure, a decrease of C3 and C4 was noted (median 21.19% and 19.68%, respectively). The CH50 and TCC follow-up showed statistically significant complement activation. Median of TCC accrual was 60.21% and median of CH50 decrease was 23.24%. No clinical manifestations of complement activation were present. With increasing number of procedures a marked decrease of TCC activation was observed in five patients, which was statistically significant in three of them (p < 0.05). This finding may indicate an immunomodulating effect of long-term adsorption therapy. With increasing number of procedures, an inhibition in complement system reactivity occurs. This result, however, has to be confirmed on a larger group of patients.
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