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Serum complement level in dengue hemorrhagic fever.

To elucidate the immunpathological changes occuring in the clinical course of hemorrhagic fever, the activity of complement and of all nine of its components activities were measured with 64 samples. These serum samples were collected from 10 cases of hemorrhagic fever with shock and 4 cases of hemorrhagic fever without shock on different days of illness. Depression of complement activity in acute phase as compared with that in the reconvalescent phase was observed in the following cases. Eight cases out of 10 of hemorrhagic shock patients showed depression of hemolytic activity of the whole complement while 3 out of 4 patients without shock showed depression. The C3 activities showed a characteristic pattern. Nine out of 10 patients with shock and 2 out 4 patients without shock showed depression on the acute phase. As for the whole complement activity in immune adherence and C4 component activities in the serum, depression in the acute phase was observed to some extent and they showed good correlation. Essentially no significant changes were observed with C1, C2, C5, C6, C7, C8 and C9 activities. Significance of the change of C3 level in clinical manifestation of immunopathological process was discussed in relation to the function and molecular structure of C3.

Acute Disease↗

Characterization of neuronal cell death induced by complement activation.

The complement system plays an important role in human immune defense mechanism. Its activation via either the classical or the alternative pathway can lead to the formation of membrane attack complex (MAC) and subsequently kills target cells. Activation of the classical pathway can be initiated with binding of C1q which is first factor of complement cascade to the Fc (fragment crystalline) region of immunoglobulin. This triggers a cascade of proteolytic events resulting in the activation of C5 convertase which cleaves C5 into C5b and C5a. The C5b then binds C6, C7, C8 to form a C5b-8 complex. Binding of C9 molecules to C5b-8 forms C5b-9, the MAC, which pore size increases as the number of C9 in the complex increases. If this membrane lesion persists and results in uncontrolled ion fluxes, the cells swell and eventually lyse. To restrict the activity of the complement system, endogenous complement inhibitors are available to regulate complement-mediated cytolysis. This enables the complement system to distinguish "self" from "foreign" and protect the host from inadvertent complement attack. Activation of the classical complement cascade has been reported in Alzheimer's disease and other neurodegenerative disorders. Recently, we demonstrated that complement activation causes neuronal cell death in vitro, and this neurodegenerative process is regulated by homologous restriction. In this article, we describe the use of two cell lines as in vitro models to evaluate cell injury/cell death induced by complement activation.

Animals↗

Decomplementation antigen, a possible determinant of staphylococcal pathogenicity.

We report the existence of an extracellular staphylococcal product, designated staphylococcal decomplementation antigen (DA), that causes rapid consumption of early-reacting complement components up to and including C5 in human serum. Complement activation occurs as a consequence of immune complex formation between DA and specific human immunoglobulin G antibodies and proceeds primarily via the classical pathway. The terminal components C7, C8, and C9 are not consumed during the process. Levels of DA production do not correlate with the expression of classical pathogenic factors, such as coagulase, clumping factor, protein A, or alpha-toxin. DA is a nondialyzable macromolecule eluting in a molecular-weight region of 70,000 to 120,000 on Sephacryl S-300 and displaying an apparent sedimentation coefficient of 3 to 4 S on sucrose density gradients. The molecule is remarkably stable and resists destruction upon boiling for 30 min or by treatment with pronase, lysostaphin, DNase, or RNase. We anticipate that DA protects staphylococci from complement attack through induction of abortive, complement-consuming reactions in the fluid phase.

Antigens, Bacterial↗

Contribution of cysteine residues to the structure and function of herpes simplex virus gH/gL.

In HSV types 1 and 2, gH forms a noncovalent heterodimer with gL. Previous studies demonstrated that the first 323 amino acids of gH1 and the first 161 amino acids of gL1 are sufficient for gH/gL binding. For gL1, substitution of any of its four cysteine (C) residues (all located within the gH/gL binding region) destroyed gH binding and function. Although gH1 contains 8 cysteines in its ectodomain, gH 2 contains 7 (C3 of gH1 is replaced by arginine in gH2). We found that mutation of any of the four C-terminal cysteines led to a reduction or loss of gH/gL function. Mutation of C5 or C6 in gH1 or gH2 rendered the proteins non-functional. However, substitution of C7 and/or C8 in gH1 has a definite negative impact on cell-cell fusion, although these mutations had less effect on complementation. Remarkably, all four gH1 N-terminal cysteines could be mutated simultaneously with little effect on fusion or complementation. As gH2 already lacks C3, we constructed a triple mutant (gH2-C1/2/4) which exhibited a similar phenotype. Since gH1 is known to bind gL2 and vice versa, we wondered whether binding of gH2 to the heterologous gL1 would enhance the fusion defect seen with the gH2-C2 mutant. The combination of mutant gH2-C2 with wild-type gL1 was nonfunctional in a cell-cell fusion assay. Interestingly, the reciprocal was not true, as gH1-C2 could utilize both gL1 and gL2. These findings suggest that there is a structural difference in the gH2 N-terminus as compared to gH1. We also present genetic evidence for at least one disulfide bond within gH2, between cysteines 2 and 4.

Animals↗

Genetic variation of the sixth component of complement (C6) in the Manx shearwater (Puffinus p. puffinus).

A polymorphism in the sixth complement component (C6) has been investigated by isoelectric focusing. The results indicate that C6 is coded by genes at a single autosomal locus. Six structural alleles have been identified, a null allele is also postulated. Five island colonies of Shearwater were investigated, two alleles C6 A and C6 B predominate in all sites. The ability of rabbit C5 and C7 to combine successfully with avian C6 indicates the functional sites of these molecules are highly conserved.

Animals↗

[Neisseria meningitidis infection. Clinical criteria orienting towards a deficiency in the proteins of the complement].

OBJECTIVE: Complement protein deficiency of the classical pathway or in proteins of the alternate pathway is rare but considerably increase the risk of infection with Neisseria meningitidis. The aim of this study was to determine the clinical criteria of the group at risk. METHODS: Retrospective study of the clinical and biological data of patients exhibiting complement protein deficiency associated with one or several N. meningitidis infections. RESULTS: Forty cases were studied, including 35 classical pathway protein deficiencies, with a predominance of C7 deficiency, 3 properdin deficiencies and 2 acquired C3 deficiencies. More than 60% of the patients exhibited recurrent N. meningitidis infections. Serogroups of rare strains were isolated in 50% of cases. Properdin deficiency was associated with a fulminating form in 2 cases out of 3. The age at onset of the first manifestations varied from 2 months to 32 years. CONCLUSION: A deficiency must be systematically searched for in all patients presenting with a N. meningitidis infection before the age of 6 months or after the age of 5 years. Identification of deficient patients permits the proposal of family screening and appropriate prophylaxis, including preventive vaccination.

Adolescent↗

Elastase of Pseudomonas aeruginosa: inactivation of complement components and complement-derived chemotactic and phagocytic factors.

A purified elastase from Pseudomonas aeruginosa was highly destructive for fluid-phase and cell-bound C1 and C3 and fluid-phase C5, C8, and C9. Inactivation of C4, C2, C6, and C7 by the enzyme varied from 0 to 67%. Low concentrations of elastase generated, then inactivated, a chemotactic factor from human C5 but not from C3. Higher enzyme concentrations inactivated the C5 chemotactic activity at a faster rate. Elastase treatment of sensitized pseudomonads containing cell-bound C3 reduced the phagocytic indexes of polymorphonuclear leukocytes. The data support the proposed chemopathogenic role of the elastase in generation of the characteristic non-inflammatory Pseudomonas vasculitis.

Animals↗

Interaction between components of the human classical complement pathway and immobilized Cibacron Blue F3GA.

The interaction between the complement components in human serum and the dye, Cibacron Blue F3GA, immobilized on cross-linked agarose (Affi-Gel Blue) has been studied. All nine components of the classical complement pathway bound to the dye and could be recovered using a linear salt gradient. With the exception of C5 and C8, all the components were eluted over a narrow NaCl concentration range, with the following yields: C1, 17%; C2, 69%; C3, 92%; C4, 87%; C6, 105%; C7, 109%; C9, 128%. C5 and C8 eluted throughout the NaCl gradient with yields of 103% and 14%, respectively. Since all components could be eluted without substantial contamination by albumin or IgG, this procedure may prove valuable as an initial step in the purification of complement components. In addition, the ability of immobilized Cibacron Blue F3GA to physicallly remove complement components may prove useful for both the decomplementation of serum and in elucidating the role of complement in immunological reactions.

Anthracenes↗

Acute-phase C56-forming ability and concentrations of complement components in normotensive and hypertensive pregnancies.

A prospective study of 61 women who were normotensive at booking revealed an increased incidence of C56-forming ability in those who later developed hypertension. Similar changes were found before delivery in a separate group of women admitted with latent hypertension and in each of 11 women with severe pre-eclampsia and a surviving fetus. The C56-forming ability, an acute phase feature, often preceded the hypertension and the findings suggest an indirect relation between complement changes and the mechanism causing hypertension in pregnancy. Concentrations of complement components in hypertensive and normotensive pregnancies were also compared with each other and with those of normal healthy non-pregnant women. The hypertensive patients had increased total alternative pathway function and higher factor B concentrations. The C56-negative sera from hypertensive patients tended to have C7 concentrations higher than normal whereas C56-positive patients had higher C5 concentrations. The aetiological and pathological implications are discussed.

Complement Activation↗

Urinary excretion of terminal complement complexes in glomerular disease.

To evaluate renal terminal complement activation in patients with glomerular diseases, we measured terminal complement complexes (TCCs) in plasma and urine with sandwich enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody against a C9 neoepitope expressed on TCC and a polyclonal antihuman C7 antibody. TCCs were detectable in plasma but not in urine in most of normal controls. In plasma, TCC levels were elevated in 4 of 22 patients with lupus nephritis and in 6 of 12 with membranoproliferative glomerulonephritis. However all patients with IgA nephritis, focal glomerulosclerosis, idiopathic membranous nephritis and idiopathic minimal change nephrotic syndrome (MC) showed normal values. In urine, TCCs were detectable in almost all patients with heavy proteinuria (greater than or equal to 100 mg/ml) except MC. The TCCs present in urine were partially purified by gel filtration using Sepharose 6B and were found to contain C5, C6, C7, C8, C9 and S protein by ELISA. Although the molecular weight of TCC is similar to that of IgM, the fractional excretion rate of TCC was about 100 times higher than that of IgM. These results suggest that TCCs detectable in urine contain SC5b-9 complexes and are mostly of renal origin.

Adolescent↗

Lysis of paroxysmal nocturnal hemoglobinuria erythrocytes by acid-activated serum.

Erythrocytes from paroxysmal nocturnal hemoglobinuria patients (PNH-E) are much more susceptible to lysis by acid-activated human serum than normal human erythrocytes. Acidification of normal human serum to pH 6.4 in the absence of erythrocytes generates this lytic activity independently of the alternative pathway of complement activation. A shift of pH of a mixture of purified human C5 and C6 to 6.4 at 0 degrees C generates a similar activity C(56)a that lyses PNH-E together with C7-C9 much more efficiently than normal erythrocytes. Since acid-activation of normal human serum occurs in the absence of C3, the acid-activated C56 appears to be the lytic principle in acidified human serum.

Animals↗

Protection of human nasal respiratory epithelium from complement-mediated lysis by cell-membrane regulators of complement activation.

Complement in the respiratory tract protects the host from invading micoorganisms and other inhaled insults, but may damage normal tissue. Recently we reported that human respiratory epithelium from the nose to the alveoli expresses three cell-membrane regulators of complement activation: membrane cofactor protein (MCP, CD46), decay accelerating factor (DAF; CD55), and CD59. In this study we investigated whether two of these complement-regulatory proteins, DAF and CD59, protect human nasal epithelial cells from complement-mediated lysis. Treatment of nasal epithelial cells in suspension with 50% or 100% normal human serum (NHS) lysed small percentages of cells (8% and 16%, respectively). Addition of complement activators, rabbit serum antinasal epithelial cells (anti-NEC), or lipopolysaccharide (LPS) increased cell lysis in the presence of 50% NHS in a dose-dependent manner up to 50% and 35% lysis, respectively. Human serum deficient in C3 or C7 did not lyse nasal epithelial cells even in the presence of anti-NEC. To assay the contribution of DAF and CD59 to cell protection against lysis, nasal epithelial cells in suspension were treated with appropriate blocking antibodies. Both anti-DAF and anti-CD59 markedly increased the susceptibility of human nasal epithelial cells to lysis by complement. At 50% NHS, anti-DAF and anti-CD59 antibodies increased epithelial cell lysis from 8% to 24% and 67%, respectively. A similar pattern of response to complement was demonstrated by monolayers of substrate-anchored cultured cells. These results indicate that DAF and CD59 protect human nasal epithelial cells from complement-mediated lysis; however, intense activation of complement may overcome this protection, leading to cell death and tissue injury. We speculate that imbalance between complement regulation and complement activation in the human respiratory tract in disease may result in tissue injury and impaired tissue function.

Adolescent↗

Terminal components of carp complement constituting a membrane attack complex.

The membrane attack complex (MAC) of carp complement was extracted with deoxycholate from rabbit erythrocytes lysed by carp serum and purified by a two-step chromatographic procedure. On two-dimensional SDS-PAGE of carp MAC, eight bands were detected. The band of M(r) 91,000 was identified as carp C9 by western blotting using anti-carp C9, and two bands of M(r) 62,000 and one band of M(r) 22,000 were confirmed as those of carp C8 alpha, C8 beta and C8 gamma, respectively, by their N-terminal amino acid sequences. The bands of M(r) 102,000 and 73,000, which generated from a 180,000 band under reducing conditions, were those corresponding to human C5b alpha and C5b beta, respectively. The remaining bands of M(r) 115,000 and 106,000 were identified as those corresponding to human C6 and C7, as determined by their molecular size, single-chain structures and similarities in N-terminal amino acid sequences to their mammalian counterparts. Densitometric scan of the gels showed the molar ratio of C5b, C6, C7, C8 and C9 in carp MAC to be 1:1:1:1:4. Based on these results, it appears that, as with mammals, the cytolytic pathway of bony fish complement is composed of five terminal components from C5 to C9.

Amino Acid Sequence↗

[The complement system. Normal values and congenital deficiencies in the adult Mexican population].

Five hundred mexican mestizos, healthy blood donors were evaluated regarding the hemolytic activity of their serum, to assess the function of the complement (C) system. One of them was hypocomplementemic and his serum was unable to promote hemolysis by either classical or alternative pathway. It had normal protein concentrations of C3 and C4, as well as immunoreactive C1, C4, C5, C6, C7 and C8, and lytic factor D. Factor B was not recognizable. It is possible that a genetic deficiency linked to genes codifying for class III products of the major histocompatibility complex is responsible for our findings.

Adolescent↗

Osteochondroma of C7 vertebra presenting as compressive myelopathy in a patient with nonhereditary (nonfamilial/sporadic) multiple exostoses.

INTRODUCTION: Osteochondromas are most commonly found in the appendicular skeleton. They occur less frequently in the spine and compression of the spinal cord is very rare. To the best of our knowledge, this is the first report of an osteochondroma arising from C7 vertebra presenting with compressive myelopathy in a patient with nonhereditary multiple exostoses. Our purpose is to report this rare presentation and its successful management, and to highlight the clinico-radiological features of this treatable condition. MATERIALS AND METHODS: A 20-year-old male with nonhereditary exostoses presented with gradual onset weakness in bilateral lower limbs, which had rapidly progressed to complete paraplegia over 1 month. The tumor was effectively treated by surgical excision along with spinal decompression. The diagnosis was confirmed by histopathological evidence complemented by clinico-radiological studies. RESULTS: There has been a complete functional recovery without any evidence of recurrence at last follow-up at 2 years. CONCLUSION: Compressive myelopathy due to an osteochondroma arising from C7 vertebra in a case with nonhereditary multiple exostoses is being reported for the first time. Both CT and MRI demonstrated the origin, size, extent and relationship of the tumor to the vertebral and neural elements. Complete recovery of functions after surgical decompression was achieved in this case. An osteochondroma of spine must always be considered in all patients with multiple exostoses who have spine pain or develop neural deficit.

Adult↗

Cleavage of the fifth component of complement and generation of a functionally active C5b6-like complex by human leukocyte elastase.

Activation by complement C3/C5 convertases of the fifth component of human complement, C5, leads to two active cleavage products: C5a, a chemotactic peptide, and C5b, the activated form of C5. Human leukocyte elastase (HLE) has long been known to also release from C5 a chemotactic, C5a-like fragment. This, however, cannot be identical with C5a, since HLE does not cleave peptide bonds at the carboxyl group of arginine, the cleavage site that separates C5a and C5b after the exposure to the complement convertases. Therefore, the question arose whether HLE is capable of releasing a functionally C5b-like product from C5. The results show that this is, indeed, so. Treatment of human C5 with HLE in the presence of C6 leads to the formation on an active C5b6-like complex that lyses non-sensitized guinea pig red cells upon addition of the terminal components C7, C8, and C9. However, since C6 is highly sensitive to the hydrolytic action of HLE, the yield of the activation complex is rather low. The results offer a third possibility for the activation of C5: 1) classical cleavage at Arg74 by complement convertases, 2) oxidation of methionine residues without cleavage, and, as shown here, 3) cleavage by elastase at (a) site(s) distal from Arg74. The three procedures may modulate the relative yield of the two activities generated from C5, C5a-like and C5b-like effects.

Animals↗

Small-molecule switches for zinc finger transcription factors.

We have developed a general approach to generate selective small-molecule switches for zinc finger transcription factors based on the notion of structural complementation. A small molecule, 2-(4'-quinoline)benzimidazole (7), was identified by screening of a heterocycle library, which functionally rescues a structurally compromised transcription factor C7-F116A/H125G-VP16. Compound 7 induces the activity of the mutant zinc finger in a luciferase-based transactivation assay by about 18-fold at 100 muM concentration. Surface plasmon resonance measurements revealed that compound 7 enhances the affinity between the mutant C7 and its cognate DNA sequence by 16-fold while a structurally analogous compound, 2-(2'-naphthyl)benzimidazole (8), showed no affinity enhancement, indicating there is a specific interaction between compound 7 and the mutant zinc finger. Taken together, these results suggest that the partial affinity recovery of the mutant transcription factor may be the mechanism for the functional rescue of the zinc finger transcription factor by compound 7.

Amino Acid Sequence↗

Complement biosynthesis by the human hepatoma-derived cell line HepG2.

The human hepatoma-derived cell line, HepG2, synthesized and secreted functional complement proteins C1r, C1s, C2, C3, C4, C5, factor B, C1 inhibitor, C3b inactivator, a small amount of C6, and trace amounts of C8; but failed to produce detectable C1q, C7, or C9. Immunochemically, C2, C3, C4, C5, and B were isolated from culture medium as proteins with molecular sizes and subunit structures identical to the corresponding components isolated from serum. C2 and factor B from cellular lysates had slightly lower molecular weights than the corresponding proteins in culture medium. C3, C4, and C5 were detected as single chain precursor molecules in cellular lysates. These results demonstrate that human C5, like C3 and C4, is synthesized as a single chain precursor that is converted by limited proteolysis to the native two-chain molecule. It also establishes the precursor-product relationship for human pro-C4 and native C4, pro-C5, and native C5.

Carcinoma, Hepatocellular↗