Anaphylatoxin Formation in Sepsis

doi:10.1001/archsurg.1988.01400290131023

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Vol. 123 No. 5, May 1988

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Anaphylatoxin Formation in Sepsis

Anders Bengtson, MD; Mats Heideman, MD, PhD

Arch Surg. 1988;123(5):645-649.

Abstract

• Complement activation and anaphylatoxin formation werestudied in 27 septic patients. The patients were treated withantibiotics and high-dose corticosteroids. Blood samples weredrawn on admission and every week thereafter. Plasma levelsof complement components C1INH, C3, C4, and C5 were low beforethe start of treatment but were above normal one week laterin both successfully and unsuccessfully treated patients. Incontrast, plasma levels of anaphylatoxins C3a/C3a_desArg andC5a/C5a_desArg were elevated on admission. After successful treatment,plasma levels of C3a/C3a_desArg and C5a/C5a_desArg returned tonormal within one week. Nine patients had ongoing sepsis oneweek after the start of treatment and a persistent rise in anaphylatoxinconcentration. They developed multisystem organ failure withrespiratory, hepatic, and renal insufficiency. In vitro studiesof Escherichia coli incubation in fresh serum indicated a dose-relatedformation of C3a/C3a_desArg and C5a/C5a_desArg. High concentrationsof methylprednisolone inhibited the anaphylatoxin formationin vitro.

(Arch Surg 1988;123:645-649)

Author Affiliations

From the Departments of Anesthesiology and Intensive Care (Dr Bengtson) and Surgery I (Dr Heideman), Sahlgren's Hospital, University of Gothenburg, Gothenburg, Sweden.

Footnotes

Accepted for publication Feb 9, 1987.

Reprints not available.

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