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Pleural fluid complement, complement conversion, and immune complexes in immunologic and nonimmunologic diseases.

G G Hunder, F C McDuffie, K A Huston

The Journal of Laboratory and Clinical Medicine

|December 1, 1977

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Complement activation in pleural fluid, indicated by C3 conversion, is linked to immune complexes in rheumatoid arthritis and lupus erythematosus. This suggests immune complexes may cause lower complement levels in these diseases.

Area of Science:

Immunology
Clinical Chemistry

Background:

The complement system plays a crucial role in immune responses.
Alterations in complement levels within body fluids can indicate disease processes.

Purpose of the Study:

To investigate complement component concentrations and immune complex levels in pleural fluids and blood from patients with various diseases.
To determine the relationship between complement activation, immune complex formation, and specific disease states.

Main Methods:

Analysis of whole complement, C4, C3, C3 conversion products, C3PA, and immune complexes in 44 pleural fluid and 41 blood specimens.
Quantification of complement components and immune complexes using specific assays.

Main Results:

C3 conversion was detected in pleural fluids from patients with rheumatoid arthritis (all 8), lupus erythematosus (5/7), congestive heart failure (2/6), and malignant diseases (9/23).

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C3PA conversion closely correlated with C3 conversion and was inversely related to whole complement, C4, and C3 levels.

Immune complex concentrations were highest in rheumatoid arthritis patients and positively correlated with C3 and C3PA conversion in pleural fluid.

Conclusions:

Reduced pleural fluid complement levels in rheumatoid arthritis and lupus erythematosus may be a consequence of complement activation by immune complexes.
Immune complex-mediated complement conversion is a significant factor in the pathogenesis of pleural effusions in certain inflammatory and autoimmune diseases.