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PubMed1989

C1q and C1 subcomponent complexes in otitis-prone and non-otitis-prone children. A prospective study of children during their first years of life.

Children with recurrent acute otitis media (rAOM) often show reduced C1q concentrations and an excess of (C1r-C1s)2 complexes. It is not known if such C1 aberrations precede development of rAOM or are a consequence of the infections. For this reason, serial investigation of C1q and C1 subcomponent complexes from birth until the age of three was performed in 113 children, 13 of whom developed rAOM. C1q concentrations at birth were found to be lower in the rAOM group than in children who did not experience acute otitis media, and were also correlated with age at the time of the first AOM episode. However, the wide variation of C1q within the groups precluded the use of C1q as a predictive marker. Excess (C1r-C1s)2 complexes were consistently absent at birth. High concentrations were found in children with established otitis media and the complexes persisted in association with recurrent disease. In conclusion, the C1 aberrations characteristic of rAOM were mainly acquired as a result of infection.

Acute Disease↗
PubMed1977

Binding of aggregated IgG to nephritogenic type 12 streptococci: influence of serum, C1 and C4.

The uptake of aggregated IgG by type 12, M protein positive (M + ve) streptococci was high in the presence of fresh serum, while the uptake by type 12, M-ve, type 1 and type 2, M + ve or M-ve streptococci was inhibited. Serum heated to 56 degrees C for 30 min inhibited the uptake of aggregated IgG by all strains tested. Purified C1q or macromolecular C1 added to heat-treated serum restituted the uptake of aggregated IgG. It was shown that C1 and C4 in fresh serum influenced the uptake of aggregated IgG by streptococci, resulting in the distinct reaction patterns observed.

Binding Sites, Antibody↗
PubMed2002

Structural biology of C1.

The classical complement pathway is a major element of innate immunity against infection, and is also involved in immune tolerance, graft rejection and various pathologies. This pathway is triggered by C1, a multimolecular protease formed from the association of a recognition protein, C1q, and a catalytic subunit, the calcium-dependent tetramer C1s-C1r-C1r-C1s, which comprises two copies of each of the modular proteases C1r and C1s. All activators of the pathway are recognized by the C1q moiety of C1, a process that generates a conformational signal that triggers self-activation of C1r, which in turn activates C1s, the enzyme that mediates specific cleavage of C4 and C2, the C1 substrates. Early work based on biochemical and electron microscopy studies has allowed characterization of the domain structure of the C1 subcomponents and led to a low-resolution model of the complex in which the elongated C1s-C1r-C1r-C1s tetramer folds into a compact, figure-of-8-shaped conformation upon interaction with C1q. The strategy used over the past decade was based on a dissection of the C1 proteins into modular segments to characterize their function and solve their three-dimensional structure by X-ray crystallography or NMR spectroscopy. This approach allows deep insights into the structure-function relationships of C1, particularly with respect to the assembly of the C1 complex and the mechanisms underlying its activation and proteolytic activity.

Animals↗
PubMed2000

[Angioedema is caused by a defect in C1-inhibitor synthesis].

Deficit of the first component of complement inhibitor (C1-inhibitor, C1-inh) may clinically be manifested as angioedema. The disease is characterized by episodic swellings of mucosa and subcutaneous tissue at different locations of the body. Laryngeal swelling can be life-threatening. The major mediators of edema are discussed to be bradykinin and C2b derived peptides. These mediators increase capillary permeability. Antifibrinolytic agents (aminocaproic acid, tranexamic acid) and attenuated androgens (danazol or stanazolol) are used for prophylaxis. Prolonged use both of them might result in more or less severe side effects. In experiments in vitro it has been shown that IFN-gamma, IL-1, IL-6 have a stimulatory effect on C1-inh synthesis. We want to verify the practical use of probiotics as natural inductors of IFN-gamma synthesis for elevating C1-inh level.

Adolescent↗
PubMed1976

C1 subcomponent conplexes in normal and pathological sera studied by crossed immunoelectrophoresis.

Selected pathological sera gave three molecular species of C1s protein on crossed immunoelectrophoresis in the presence of calcium. C1s precipitates were obtained at the origin and in the beta1 and alpha2 regions. 12 normal sera gave C1s protein peaks at the origin and in alpha2 position. One of the normal sera also contained a small amount of the beta1 C1s protein. The C1s protein at the origin represented macromolecular C1. The alpha2 peak was a complex composed of C1 IA, C1s and C1r proteins. This complex was preformed in serum and did not show C4 cleaving activity. The molecular species in the beta1 region was shown to be a calcium-dependent complex of C1r and C1s, probably in proenzyme form. the C1r-C1s complex formed macromolecular C1 on addition of purified C1q to serum. During electrophoresis activation of C1 subcomponents was initiated by a mechanism involving CIr with generation of CIs activity in eluted fractions corresponding to the position of macromolecular C1 as well as in the beta region. The significance of beta1 C1s complexes or of alpha2 C1s complexes in normal and pathological sera was discussed.

Angioedema↗
PubMedDate not supplied

[Laboratory diagnosis and antibacterial therapy in joint diseases].

The indication for arthrocentesis is a difficult medical decision. Once obtained, however, puncture fluid is unique and important examination material which should always be thoroughly analyzed for diagnostic purposes, and also stored in a serum bank. In addition to the total protein and/or albumin fractions, the individual immunoglobulins in particular have proved to be a key parameter: they enable mechanical, hydro, inflammatory, and chronic-inflammatory processes to be distinguished. Especially in combination with the serum value, CRP is the best marker for acute inflammatory and traumatic changes. Determination of complement factors C1, C4, and C3, also of total complement activity, CH50 and of rheumatism factors, enables chronic-immunologic/rheumatic conditions to be diagnosed and their course evaluated. Bacteriologic study of punctates should always be included--not least as confirmation for the examiner--as also should cytologic and histologic examination of the sediment. Since, with bacterial etiology, the infections concerned are usually in their later stages, e.g., gonorrhea, yersinia, rubella, arthritis, antibody assays should always be performed in the serum and the joint in addition to these tests. Controversy still surrounds the question of local binding of immunoglobulin antibody complement components in the synovia itself; the present authors' findings hitherto also fail to furnish any definitive data on this issue.

Arthritis, Infectious↗
PubMed1983

C1q binding and C1 activation by various isolated cellular membranes.

Cellular and subcellular membranes obtained from heart, liver, and brain tissue from human, baboon, bovine, rabbit, and rat bound highly purified, radioiodinated human C1q with a high affinity (Ka = 10(8) to 10(10) M-1). The majority of these membrane preparations were able to activate fully assembled C1 as evidenced by the conversion of 125I-C1s, incorporated into C1 complexes, to 125I-C1s. C1 activation by baboon heart mitochondrial membranes required an intact C1 complex and appeared to be mediated by the binding of the C1q subcomponent in that excess C1q completely blocked C1 activation. Several experiments suggested that the heart mitochondrial membrane binding site for C1q is an integral component of the mitochondrial membrane and that C1q interacted with the membrane binding site through its globular head regions. It is suggested that the binding of C1q and the activation of C1 by cellular and subcellular membranes may be involved in the initiation and/or enhancement of the inflammatory process after acute tissue damage.

Animals↗
PubMed1980

Analysis of receptor-mediated C1q binding to human peripheral blood mononuclear cells.

The binding of C1q to human peripheral blood leukocytes has been investigated. Studies with fluorescein conjugated F(ab')2 anti-C1q show that few (0 to 4%) normal leukocytes isolated in the presence of EDTA have C1q on their surface. However, approximately 26% of the mononuclear cell population is able to bind added C1q. Quantitative binding studies using 125I-C1q show that the binding to mononuclear cells is specific, saturable, and reversible. Scatchard plot analyses indicate an approximate equilibrium constant of 1.2 times 10(7) M-1. C1q binding appears to be mediated via the collagenous portion of the molecule in that 1) type I collagen inhibits this binding; 2) C1 reconstituted from purified C1q, C1r, and C1s does not bind to mononuclear cells, whereas the same amount of free C1q binds avidly; and 3) C1q enhances the binding of aggregated IgG to mononuclear cells.

Binding Sites↗
PubMed1984

Hereditary Angio-Edema (HAE).

Hereditary Angio-Edema (HAE) is manifested by recurrent attacks of acute circumscribed edema of the extremities, face, trunk, and respiratory or abdominal tract, occurring after minor physical or emotional trauma, or spontaneously. The clinical diagnosis can be confirmed by low serum-levels of the inhibitor of the activated first component of complement (C1-INH). A family of 35 members over six generations was investigated. About 40 per cent of the members were HAE-patients. An autosomal dominant inheritance with high penetrance was present. Four patients died by suffocation from laryngeal edema. In all HAE-patients the C1-INH serum-level was diminished, and also in two children who have yet had no complaints. Adequate medical advice, including the provision of a medical alert card and the prescription of C1-INH concentrate (for short-term prophylaxis and the treatment of attacks of laryngeal edema), is necessary. In patients with frequent serious attacks, long-term prophylaxis with Danazol is indicated.

Abdomen↗
PubMed1977

Proenzymic C1s associated with catalytic amounts of C1r. Study of the activation process.

1. Proenzymic C1s isolated from human plasma by euglobulin precipitation and DEAE-cellulose chromatography is associated with trace amounts of C1r (0.5--1% on a molar basis). Incubation for 2 h at 37 degrees C leads to the proteolytic activation of C1s. The proteolysis is characterized by the sigmoidal appearance of C1s esterase activity and of the typical heavy (57 000-dalton) and light (28 000-dalton) fragments of C1s on sodium dodecyl sulphate-polyacrylamide gel electrophoresis. 2. The C1s activation process observed is markedly temperature and concentration dependent, and the rate of activation is decreased by calcium and high ionic strength (I = 0.9). Diisopropyl phosphorofluoridate, benzamidine, polyanethol sulfonate and pentosane polysulphate inhibit the activation, which is also sensitive to C1-inactivator and anti-C1r IgC. From the kinetic experiments and from the inhibition characteristics, the activation of C1s can be attributed to the presence of C1r, which appears to undergo activation and then to activate secondarily C1s.

Calcium↗
PubMed1988

A monoclonal antibody to C1q which appears to interact with C1r2C1s2-binding site.

A monoclonal antibody (SB-4) to human C1q was prepared. The equilibrium constant of the antibody for C1q was found to be greater than 10(10) M-1. It has been shown that the antibody binds to the A-B chain dimer, probably via the B chain of C1q. Pepsin digestion of C1q at pH 4.5, which fragments the globular regions but leaves the collagenous region intact, allowed the demonstration that the antigenic site is located in the collagenous region of the molecule. The effect of the antibody on haemolytic activity has shown that it is capable of inhibiting the formation of EAC1 cells from EAC1q cells plus C1r and C1s but is incapable of inhibiting the C1 activity of performed EAC1 cells. This indicates that the binding of the antibody to the collagenous portion of the B chain of C1q probably prevents interaction between C1q and the C1r2-C1s2 complex.

Antibodies, Monoclonal↗
PubMed1989

Acceleration of site-to-site transfer of C1- by a monoclonal antibody to C1-s.

A monoclonal antibody to human C1-s (a subcomponent of C1-), M365 blocked the complement-mediated lysis of C1(-)-coupled IgM-sensitized sheep erythrocytes (EAIgMC1). However, M365, via its binding to C1-s, did not inhibit C2 activation and only partially inhibited C4 activation, both attributable to the proteolytic action of C1s. Therefore, the inhibition of lysis of EAIgMC1 is not due to the direct effect of antibody binding to C1-s in the C1- molecule. M365, when added to the pre-formed EAIgMC1, deprived the whole C1 molecule from the cells. It was also found that M365-bound C1 could not bind to EAIgM. These phenomena were induced only when M365, one of seven monoclonal antibodies to C1-s, was employed and when IgM antibody-sensitized E was used. The observed C1- liberation and C1 binding inhibition by M365 were found to be less effective when the C4b bearing cells, EAIgMC4, were used. But the addition of M365-bound C1- to EAIgMC4 promoted the formation of the C3 convertase, C4b2a, which caused an incremental lysis of the C4b bearing cells. The results are interpreted to mean that C1-, once complexed with M365, still remains active and acquires the ability to transfer from one C1 binding site on IgM to another to activate the convertases. C4b must be a prerequisite on the cells to induce the effective C1- transfer and resulting increase of C3 convertase sites. We hypothesize that the M365-C1-s association alters the conformation of C1q and thereby leads to the dissociation of whole C1- from IgM. The M365-C1- complex, therefore, can move from site to another.

Animals↗
PubMed1989

Further evidence for dilution-dependent dissociation of C1q in human serum.

Dissociation of the C1q subcomponent in native C1 upon dilution was reexamined by using ultracentrifugation in a sucrose gradient and high performance liquid chromatography system with a size exclusion column for separating the dissociated C1q fractions. The antigenic content of C1q in each fraction was detected by ELISA and Western blotting; binding to erythrocyte antibody was also determined. The results confirmed a previous claim that C1q in native C1 dissociated as a function of dilution: up to 14.5% of C1q antigen was in the low molecular weight form (approximate S value: 4-5). Commercial preparations of purified C1q also contained C1q antigen in the low molecular weight form.

Centrifugation, Density Gradient↗
PubMed1981

A kinetic analysis of immune-mediated clearance of erythrocytes.

A mathematical expression has been derived that successfully correlates the kinetic data for the immune-mediated clearance of red blood cells. The expression resulted from the solution of differential equations arising from a clearance mechanism that was, essentially, consistent with that described by Schreiber and Frank. The mathematical expression correlated data for both IgG-and IgM-mediated reactions. Four different rate constants appear in the final kinetic equation; these constants, which measure the rates of the various steps in the clearance process, were evaluated by an iterative curve-matching process. The values of the rate constants were found to be dependent upon type of sensitizing immunoglobulin, number of C1-fixing sites, and several known immune system modifiers. Correlation of the derived rate expression with the experimental data provided a critical test for the Schreiber-Frank mechanism and the values of the rate constants provided additional insights into the immune clearance process.

Animals↗
PubMed1981

Circulating immune complexes, complement factors C3, C4, C1-inhibitor, alpha-1-antitrypsin and immunoglobulins in asthmatic patients.

Sera from 159 adult asthmatic outpatients (extrinsic, n = 82, intrinsic, n = 65 and acetylosalicylic acid (ASA)-sensitive, n = 12) and from 100 controls were tested for total levels of IgG, IgM, IgA, IgE, complement factors C3, C4, C1-inhibitor, alpha 1-antitrypsin and circulating immune complexes. The following results were observed: (1) a marked increase of IgE in extrinsic asthma; (2) a slight increase of IgM, and (3) an equal increase of complement C4 levels in all three asthma groups; (4) normal mean values of C3 levels with a significantly larger standard deviation of the mean in all three asthma groups; (5) an equally slight decrease of protease inhibitors, such as C1-inhibitor and alpha 1-antitrypsin, and (6) the presence of circulating immune complexes in 22% of extrinsic, in 8% of intrinsic and 13% of ASA-sensitive asthmatics. Circulating immune complexes can be found in all three asthma groups and may correlate with complement deviation.

Adult↗
PubMed2003

Acute upper airway angioedema secondary to acquired C1 esterase inhibitor deficiency: a case report.

PURPOSE: Adverse reactions to local anesthetics are widely reported. We report a case of acute upper airway angioedema presumed to be due to the local anesthetic articaine, which was subsequently diagnosed as acquired C1 esterase inhibitor deficiency. CLINICAL FEATURES: A 54-yr-old woman presented with a history of progressive facial and periorbital edema 24 hr after receiving articaine local anesthetic for a dental procedure. She was in mild respiratory distress but was not stridorous. After inhalational induction with sevoflurane in the operating room, direct laryngoscopy revealed marked edema of supraglottic structures including epiglottis, uvula and aryepiglottic folds and the larynx was not visualized. The patient's trachea was intubated under direct laryngoscopy. Seventy-two hours later, the endotracheal tube was removed and she made an uneventful recovery. Initially, the angioedema was thought to be caused by a hypersensitivity reaction to articaine. Later investigations showed normal C3 complement level, very low C4 complement and C1 esterase inhibitor levels confirming a diagnosis of C1 esterase inhibitor deficiency. Subsequently, the patient was started on androgen therapy. Her C1 esterase inhibitor level normalized and she remained symptom free nine months after initial presentation. CONCLUSION: We report a case of acute upper airway angioedema secondary to C1 esterase inhibitor deficiency requiring emergency airway management. Anesthesiologists should consider C1 esterase inhibitor deficiency in the differential diagnosis of patients with airway edema and be familiar with the acute and prophylactic treatment of patients with this diagnosis.

Acute Disease↗