Bell's palsy: an immune complex disease

Serum levels of C4-containing circulating immune complexes in 48 patients with Bell's palsy were studied by an enzyme-linked immunosorbent assay (ELISA) using chicken antibodies. We have previously reported elevated levels of C1q- and C3-containing immune complexes when compared to the serum of 42 healthy persons. We now found the levels of C4-containing immune complexes in these sera to be slightly decreased, but these patients' sera had a slightly increased ability to activate and bind C4 to a model immune complex. The results indicate that the fairly low levels of C4-containing immune complexes were not due to a defect in C4 activation but point to a rapid modification of C4 in the immune complex in vivo or low binding of C4 to the immune complexes. This study also shows that it is preferable to use assays that detect C1q- and C3-containing immune complexes when analyzing sera from patients with Bell's palsy.