Component deficiencies. 2. The fourth component.
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Biomedical subjects
Publications and source records attributed to J Goetz.
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Complement may be activated by anaesthetic agents as well as contrast media, and so could anaphylactoid reactions be induced. Efficient and harmless complement blocking agents were still lacking. The only agents actually used by anaesthetists were steroids and/or antifibrinolytic drugs. Other agents were not indicated in surgical patients because of their adverse effects and the impossibility of giving them by the intravenous route.
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The polymorphism of the second component of human complement (C2) was studied by means of isoelectric focusing in polyacrylamide gels followed by immunoblotting with a specific antihuman C2 antibody. The polymorphism was studied in native C2 and in the C2a fragment obtained by activation of the classical pathway with heat-aggregated human IgG. Serum samples previously typed with the hemolytic overlay technique were analyzed. They comprised samples of homozygous C2*C, C2*B, C2*Q0, heterozygous C2*BC and C2*CQ0 individuals. The patterns obtained by immunoblotting corresponded to those obtained by the hemolytic overlay technique. As expected, the homozygous C2*Q0 sample (complement C2 deficiency) did not show any band pattern. The C2a fragment presented also a polymorphic variation which correlated exactly with the native C2 polymorphism. It appears thus that the polymorphic site of the C2 protein is carried by the C2a fragment for the C2*C and C2*B variants. In addition, this method is easier to perform than the common hemolytic overlay technique and the rare C2-deficient serum is not needed.
Phospholipid-binding antibodies are heterogeneous immunoglobulins of G and/or M and/or A class which can be detected in association with a variety of pathologies. However they can also occur in the absence of any clinical manifestations. Despite their paradoxical in vitro anticoagulant activity, phospholipid-binding antibodies, either primary or secondary, are frequently associated with venous and/or arterial thrombotic events. Hence, their detection has to be performed in several major clinical situations, cerebral attack, myocardial infarction, recurrent fetal loss, deep vein thrombosis ... Their course has to be controlled at least every six months. Since the incidence of phospholipid-binding antibodies in auto-immune pathologies is high, immunological disorders should also be considered. As yet there is no standardized assay of phospholipid-binding antibodies, either functional with respect to their anticoagulant activity, or immunological (ELISA). It is not established whether they possess an own pathogenic potential or appear as a secondary response following cellular alterations known to be thrombogenic. However it has been suggested that they could participate in the disruption of the hemostatic balance towards procoagulant tendency resulting in thrombosis.