Bypass-activation of the complement system starting with C3. II. C3-activation by gamma-1-immune aggregates in guinea pig serum

Intraoperative allergic reactions to hydroxyethyl starch: a report of two cases

The presentation, evolution, and treatment of two cases of intraoperative allergic reactions are described. In each case, the offending agent was felt to be hydroxyethyl starch (HES), a synthetic polymer colloid solution used for intravascular volume expansion. Symptoms included urticaria, angioedema, and hypotension in the first patient, and urticaria, hypoxia, and haemoconcentration in the second patient. Both patients had earlier received multiple drugs and/or blood products. However, HES administration in both patients immediately produced allergic symptomatology. The first patient had concurrent depression of serum total complement levels (CH50) and no elevation of plasma histamine levels, which suggested a complement-mediated reaction to HES. Levels of CH50 and histamine were not obtained from the second patient. Direct stimulation of mast cell degranulation by the offending agent, complement activation, or conventional antigen-antibody interaction in a previously exposed patient may initiate intraoperative allergic reactions. Anaesthesia personnel should be aware of the risk of intraoperative allergic reactions to HES and be prepared to treat them rapidly and effectively.

A comparative analysis of macrophage activation in C57B1/6 mice treated with inflammatory compounds or bearing Lewis lung carcinoma

The different percentages of acid hydrolases released by peritoneal macrophages obtained from C57B1/6 mice injected i.m. with talc, carrageenan or 3LL cells, and also the demonstration that hydrolase secretion from in vitro macrophage monolayers of tumor-bearing mice undergoes a further increase when zymosan is added to the culture, strongly suggest the possibility that more than one membrane surface receptor is involved in the triggering of lysosomal enzyme release. Furthermore, there is evidence from the reported results that, besides immune complexes, neoplastic cells or their metabolic product(s) could act as inducers of the lysosomal enzyme secretion by macrophages.

Quantitation of serum complement components and plasma C3d in patients with malignant lymphoma: relation to the stage of the tumor and circulating immune complexes

Total hemolytic complement activity (CH 50) and complement component levels were measured in 27 patients with Hodgkin's disease and 31 patients with non-Hodgkin malignant lymphoma. CH 50 values were higher than normal in almost all the patients. Increased levels of serum C4, C3 and factor B were observed in 62%, 31% and 19% of these patients, respectively. However, plasma concentration of C3d, a breakdown product of C3, was elevated in 29% of the cases. The hypercatabolism of C3 was not closely associated with the presence of circulating immune complexes, as assessed by the C1q binding assay, nor with the presence of general symptoms in the patients. On the contrary, it appeared to be in relation with the extent of the malignant disease.

Zymosan-induced arthritis: a model of chronic proliferative arthritis following activation of the alternative pathway of complement

Zymosan particles, which are able to activate complement by the alternative pathway and to induce enzyme secretion from macrophages, were injected into knee joints of mice. After various time intervals, synovia were assessed histologically for various markers of inflammation. Within 7 days after intraarticular injection of zymosan, a chronic inflammatory arthritis with mononuclear cell infiltration, synovial hypertrophy and pannus formation was observed. Latex particles, which do not activate complement or macrophages, produced only mild, transient inflammatory reactions.