COMPLEMENT ACTIVATION PRECEDING, DURING AND AFTER THE ADULT RESPIRATORY DISTRESS SYNDROME.
Contributors: Rush University, College Of Nursing.
Published: 1987
Number of pages: 134
Subjects: Health Sciences, Immunology.; Health Sciences, Nursing.
Description: Extensive investigations, conducted to identify a diagnostic marker for the adult respiratory distress syndrome (ARDS), have produced inconclusive results. Although complement activation products have been detected in blood samples from patients with ARDS, detection of individual complement components or cleavage products did not discriminate the early onset of this clinical syndrome. The present investigation measured complement activation by enzyme immunoassay quantification of stable by-products of the reaction, namely the terminal complement complex (TCC), formed on assembly of C5b-9, and C1rC1s-C1 inhibitor complex and C3bP complex, generated after activation of the classical and alternative pathways, respectively. In this prospective study of 139 critically-ill patients, 17 of whom developed ARDS, there were significant elevations in plasma TCC concentrations (P = 0.02) two days prior to the onset of ARDS, and in plasma levels of the C1rC1s-C1 inhibitor complex (P = 0.004),TCC (P = 0.008) and C3bP complex (P = 0.01) one day preceding its resolution. ARDS- sepsis, ARDS-trauma and ARDS-disseminated intravascular coagulation (DIC) patients had greater C1rC1s-C1 inhibitor complex and C3bP complex concentrations than septic non-ARDS, trauma non-ARDS and DIC non-ARDS patients, respectively, indicating activation of both classical and alternative pathways in ARDS. TCC and C1rC1s-C1 inhibitor complex concentrations were the only complement components able to distinguish between ARDS and non-ARDS patients, irrespective of the predisposing clinical condition. Results from this investigation indicate that the quantification of by-products of complement activation provides a more sensitive measure of ARDS than do measurements of C3a desarginine, C5a desarginine and total hemolytic complement activity. These studies further suggest that plasma TCC, C1rC1s-C1 inhibitor complex, and C3bP complex levels may be useful in the clinical evaluation of patients at risk for ARD
Notes: Source: Dissertation Abstracts International, Volume: 48-09, Section: B, page: 2599.

Thesis (D.N.SC.)--RUSH UNIVERSITY, COLLEGE OF NURSING, 1987.

School code: 0591.