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The development of the complement system after 28 weeks' gestation
1Department of Paediatrics, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.
Insights
Complement levels are significantly lower in preterm and full-term infants compared to adults. The complement system shows minimal development before 33 weeks of gestation in preterm infants.
Area of Science:
- Immunology
- Neonatology
- Pediatric Research
Background:
- The complement system is crucial for immune defense.
- Understanding complement development in neonates is vital for assessing infection risk.
Purpose of the Study:
- To evaluate complement component levels and activity in preterm infants.
- To determine the developmental trajectory of the complement system in relation to gestational age.
Main Methods:
- Measured complement activities (CH50, AP50) and components (C1q-C9, Factor B, properdin).
- Studied preterm infants (28-33 weeks GA and 34-36 weeks GA), full-term neonates, and healthy adults.
- Correlated complement levels with gestational age, birth weight, delivery type, and gender.
Main Results:
- Complement levels and activity were significantly reduced in neonates (preterm and full-term) versus adults.
- C8 and C9 levels were markedly reduced across all gestational ages.
- Complement levels showed a significant positive correlation with gestational age.
- No significant correlation was found between complement levels and birth weight, delivery type, or gender.
- The complement system demonstrated minimal development between 28 and 33 weeks' gestation.
Conclusions:
- Preterm and full-term neonates have immature complement systems compared to adults.
- Gestational age is a key determinant of complement system development in infants.
- Infants born before 33 weeks gestation exhibit particularly underdeveloped complement pathways, potentially increasing infection susceptibility.
Objective:
To assess the levels and development of the various complement components in preterm infants, particularly among those born before 34 weeks' gestation.
Subjects And Methods:
We measured the complement system's activities (CH50 and AP50) as well as its various components (C1q,r,s, C2-C9, Factor B, and properdin) in 25 preterm infants [gestational age (GA) 28-33 weeks], 35 preterm infants (GA 34-36 weeks), 50 full-term newborn infants (GA 37-42 weeks), and 49 healthy adults as control subjects.
Results And Conclusions:
The results of these studies are: (i) complement levels and activity were significantly reduced in preterm and full-term neonates when compared with adult levels, with the exception of C7 which was within the normal range in most infants. C8 and C9 were the most markedly reduced at all gestational ages. (ii) Complement levels correlated significantly with gestational age, but not with birth-weight, type of delivery, or gender. (iii) Between 28 and 33 weeks' gestation, there appeared to be almost no development of the complement system.