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The complement system is activated in a biphasic pattern after coronary artery bypass grafting

Cornelia Hoedemaekers1, Marcel van Deuren, Tom Sprong

  • 1Department of Intensive Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. C.Hoedemaekers@ic.umcn.nl

The Annals of Thoracic Surgery
|February 23, 2010
PubMed

Insights

Complement activation after coronary artery bypass grafting (CABG) follows a biphasic pattern. Early activation involves classical and alternative pathways, while later stages show classical activation with engaged inhibitory mechanisms.

Area of Science:

  • Immunology
  • Cardiovascular Surgery
  • Inflammation

Background:

  • The complement system plays a crucial role in the inflammatory response post-coronary artery bypass grafting (CABG).
  • Understanding the precise pathways of complement activation and deactivation after cardiac surgery remains unclear.
  • This study aimed to elucidate the routes of complement activation following uncomplicated CABG.

Purpose of the Study:

  • To analyze the specific pathways involved in complement activation after uncomplicated coronary artery bypass grafting.
  • To investigate the temporal dynamics of complement activation and deactivation post-cardiac surgery.

Main Methods:

  • Measurement of complement components and activation products in 20 adult patients undergoing elective CABG.
  • Serial sampling from intensive care unit admission through postoperative recovery.

Main Results:

  • Complement activation exhibited a biphasic pattern post-CABG.
  • Initially (0-8 hours), activation involved classical/lectin and alternative pathways, leading to terminal complement complex formation.
  • Later (post-8 hours), activation was primarily via the classical/lectin pathway without alternative pathway augmentation or terminal complex formation, suggesting engagement of inhibitory mechanisms.

Conclusions:

  • Complement activation following cardiac surgery is a complex, biphasic process.
  • Inhibitory mechanisms appear to be engaged approximately 8 hours postoperatively, modulating the complement response.
Abstract

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