The Alternative Pathway of Complement Activation in the Neonate
The Alternative Pathway of Complement Activation in the Neonate
复制标题
新生儿补体激活的替代途径
DOI：
10.1203/00006450-197510000-00012
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发表时间：
1975
影响因子：
3.6
通讯作者：
S. Kaplan
中科院分区：
文献类型：
--
作者：
P. Feinstein;S. Kaplan
摘录：将C3PA(B因子)浓度作为新生儿和成人交替途径发育的指标进行了比较。脐带血清的平均水平为39±2%，范围为19.5~77.5%。正常成人平均水平为74±4%，范围为43~108%。两者之间的差异非常显著(P<；0.001)。新生儿C3PA与成人C3PA的比值为0.52±0.10。只有一例新生儿水平高于成人平均水平。胎龄与胎龄呈正相关，r=0.18，但无统计学意义(P>；0.1)。男婴和女婴之间无差异。将C3PA浓度与C3浓度进行比较，并绘制成曲线图。虽然相关系数r=0.22，但无统计学意义(P=0.1)。在革兰氏阴性败血症婴儿中，C3PA浓度远高于正常脐带血清的平均值。它们也高于正常成年C3PA耕作者的平均值，倍数为1.8-2.5。第一次测定，在正常到轻微升高的两天后，发现值为132±6%。第二次测定的峰值为101.5°F，是三升中最高的，为185±4%。在C3PA水平达到这一峰值的同时，发烧降到了正常水平。到最后一次测定时，C3PA水平已恢复到原来的125±4%，这表明正常足月新生儿脐带血清中C3和C3PA水平与成人对照组相比是缺乏的。C3和C3PA与胎龄无关。随着C3滴度的增加，C3PA水平稳步上升，与成人值的可比比率表明，替代途径可能正在以与经典途径相同的速度成熟。败血症婴儿的结果可能代表了对炎症条件的反应(急性期现象)，替代途径表达受阻，或C3PA分解代谢增加以外的合成。推测：替代途径的发展可能与负责其合成的器官系统的成熟平行，尽管胎盘机制(平衡或产生抑制物质)并未被排除为新生儿该系统IHE状态的一个因素。对足够数量的革兰氏阴性新生儿的异常发现进行调查，以评估补体激活的替代途径在新生儿这种疾病的发病机制和预后中的作用。
Extract: C3PA (factor B) concentrations taken as an indication of alternate pathway development for neonates and adults were compared. The mean level for umbilical cord sera was 39 ± 2%, with a range of 19.5–77.5%. The normal adult mean level was 74 ± 4%, with a range of 43–108%. The difference between the two is highly significant (P < 0.001). The ratio of neonatal C3PA to adult C3PA is 0.52 ± 0.10. In only one case was the newborn level greater than the mean adult value. There is positive correlation, r = 0.18, with gestational age, although it falls short of statistical significance (P > 0.1). There were no differences between the male and female neonates. C3PA liters were compared with C3 concentrations and so plotted. Although there was a positive correlation, r = 0.22, it was not statistically significant (P = 0.1).In an infant with gram-negative septicemia, the C3PA concentrations were much greater than the mean value found in normal cord sera. They were also greater than the mean value for normal adult C3PA tilers, the multiple being 1.8–2.5. On first determination, after 2 days of normal to slightly elevated temperatures, a value of 132 ± 6% was found. The second determination with a spike to 101.5° F, and gave the highest of the three liters, 185 ± 4%. At the same time that the C3PA levels reached this peak, Ihe fever dropped lo normal. At the time of the last delermination, the C3PA levels had returned to that of the original sample, 125 ± 4%.This sludy demonstrates lhal Ihe cord sera of Ihe normal term neonate is deficient in C3 and C3PA when compared with adult controls. Neither C3 nor C3PA correlated with gestational age. C3PA levels increase steadily as C3 titers increase and comparable ratios to adult values indicate that the alternate pathway is probably maturing at the same rate as the classic pathway. The results in the septic infant may represent a response to an inflammatory condition (acute phase phenomena), a block in alternate pathway expression, or synthesis beyond increased C3PA catabolism.Speculation: The development of the alternate pathway probably parallels the maturation of the organ systems responsible for its synthesis, although placental mechanisms (equilibration or production of an inhibitor substance) have not been excluded as a factor in Ihe status of this system in the neonate. Investigation of Ihe abnormal findings in an adequate sample of neonates wilh gram-negalive is indicated to assess Ihe role of the alternate pathway of complement activation in the pathogenesis and prognosis of this condition in the neonate.