Complement levels and exposure in the hypobaric chamber

Decompression sickness sometimes occurs in routine hypobaric chamber runs. Susceptibility to decompression sickness has been correlated with increases in C3a and C5a metabolites of complement activation by air bubbles. If personnel susceptible to decompression sickness show changes in C3a and C5a after decompression, then measurement of these metabolites may be useful in assisting diagnosis. C3a and C5a metabolites of complement activation were measured in 11 male and 2 female volunteers 1 h before (A), 1 h after (B), and 24 h after (C) exposure in routine hypobaric chamber runs to 25,000 ft equivalent altitude. The results were compared with 4 controls (3 males and 1 female). A one-way analysis of variance showed no significant difference between the experimental and control groups overall (p = 0.308; p > 0.05; N = 17). T-tests at each of the results further suggest non-significant differences between the experimental and control groups (p = 0.473; p = 0.341; p = 1.051; p > 0.05; N = 17) at results A, B, and C, respectively. The C5a assay was less than 10 micrograms.L-1 in all individuals, and the particular kit used was not sensitive below 10 micrograms.L-1. As none of the participants developed decompression sickness, it would be useful to determine levels of C3a and C5a in individuals who subsequently develop decompression sickness. One member of the experimental group who had undergone many chamber runs had much higher pre- and post-chamber run levels of C3a. This raises the question of the effect of repeated exposure in low pressure chambers on complement activation, and requires further study.