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Terminal complement complex in septic shock with capillary leakage: marker of complement activation?
T Schuerholz1, M Leuwer, M Cobas-Meyer
1Friedrich Schiller University, Department of Anaesthesiology and Intensive Care, Jena, Germany. tobias.schuerholz@med.uni-jena.de
European Journal of Anaesthesiology
|July 28, 2005
Summary
Plasma levels of terminal complement complex (C5b-9) may not reliably indicate complement activation in septic shock with capillary leak syndrome, despite tissue deposition.
Area of Science:
- Critical Care Medicine
- Immunology
- Nephrology
Background:
- Sepsis-induced septic shock often involves capillary leak syndrome.
- Complement activation is implicated in the pathophysiology of septic shock.
- Terminal complement complex (C5b-9) is a marker of complement system activation.
Purpose of the Study:
- To evaluate terminal complement complex (C5b-9) plasma levels as a marker for complement activation.
- To assess the relationship between C5b-9 and capillary leak syndrome in septic shock.
Main Methods:
- Prospective animal study using pigs with induced fecal peritonitis.
- Measurement of albumin escape rate to quantify capillary leak.
- Quantification of plasma C5b-9 levels via immunoassay.
- Immunohistological analysis of renal specimens for C5b-9 deposition.
Main Results:
- Septic animals exhibited a significantly increased albumin escape rate (+52%) compared to controls (+3%).
- Plasma C5b-9 levels decreased over the study period in both septic and control groups.
- Significant deposition of C5b-9 was observed in renal specimens of septic animals.
Conclusions:
- Complement activation was confirmed by renal C5b-9 deposition in septic shock.
- Decreasing plasma C5b-9 levels during the study suggest it may not be a reliable marker in this context.
- Plasma C5b-9 levels may not accurately reflect complement activation in septic shock with capillary leak syndrome.