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Anaphylatoxin formation in extracorporeal circuits.
Complement (Basel, Switzerland)
|January 1, 1986
Summary
Complement activation during extracorporeal circuits, like hemodialysis and cardiopulmonary bypass, was measured. C3a antigen levels indicated activation, while C5a promoted granulocytopenia, suggesting a role in adverse effects.
Area of Science:
- Immunology
- Biomedical Engineering
Background:
- Extracorporeal circuits (ECC) like hemodialysis and cardiopulmonary bypass can activate the complement system.
- Understanding complement activation is crucial for improving the biocompatibility of medical devices.
Purpose of the Study:
- To define the temporal profile and extent of complement activation in ECC.
- To identify key anaphylatoxins involved in ECC-induced complement activation and associated clinical sequelae.
Main Methods:
- Radioimmunoassay techniques were used to measure plasma levels of anaphylatoxins (C3a, C4a, C5a).
- Prospective studies were conducted on patients undergoing maintenance hemodialysis and cardiopulmonary bypass.
- Granulocyte activation and granulocytopenia were monitored as indicators of C5a activity.
Main Results:
- Plasma C3a antigen levels were sensitive indicators of intravascular complement activation in ECC.
- Plasma C5a levels remained relatively stable but correlated with granulocyte activation and transient granulocytopenia.
- Elevated C4a and C3a levels were observed after protamine sulfate administration, indicating classical pathway activation.
Conclusions:
- The alternative complement pathway is predominantly activated in hemodialyzers and bypass oxygenators.
- C5a anaphylatoxin may mediate adverse clinical effects associated with ECC.
- These findings aid in designing more biocompatible medical devices and understanding anaphylatoxin roles in disease.