Subject(s)
Complement C3a/analogs & derivatives , Sepsis/physiopathology , Acute-Phase Proteins/blood , Amino Acids/blood , Anaphylatoxins/blood , Arteries , Biomarkers , Complement C3/analogs & derivatives , Complement C3/metabolism , Endotoxins/blood , Humans , Orosomucoid/metabolism , Oxygen/blood , Oxygen Consumption , Pancreatic Elastase/blood , Prognosis , VeinsABSTRACT
We investigated whether cooling of the extracorporeal blood during hemodialysis could prevent anaphylatoxin generation and leukopenia caused by blood-cuprophan contact. After preliminary in vitro studies confirming the temperature dependence of C5a generation, we carried out hypothermic dialysis on nine patients by manipulating blood and dialysate temperature in such a way that blood temperature within the dialyzer averaged 25 degrees C. In comparison with the control procedure (blood temperature within the dialyzer 35 degrees C) hypothermic dialysis reduced peak C5a generation from 41.7 +/- 17 ng/ml to 9.7 +/- 3.4 ng/ml (P less than 0.01), and white blood cell fall from 72 +/- 15 to 25 +/- 20% (P less than 0.01). Arterial PO2 decreased less in hypothermic dialysis (-19 +/- 9% of pre-HD value) than in the control procedure (-30 +/- 11%) (P less than 0.05). We conclude that blood cooling attenuates cuprophan-induced anaphylatoxin generation and leukopenia.
Subject(s)
Anaphylatoxins/blood , Blood , Cellulose/analogs & derivatives , Cryotherapy , Peptides/blood , Adult , Aged , Cellulose/adverse effects , Complement C5/metabolism , Complement C5a , Female , Humans , Male , Middle Aged , Neutropenia/blood , Renal Dialysis/methodsABSTRACT
To study the possible involvement of the complement system in inflammatory skin disorders, we measured the concentrations of C3a and C4a anaphylatoxins in the peripheral blood of 148 patients with various inflammatory skin disorders and 48 healthy control subjects by radioimmunoassay. Significant increases in mean levels of both C3a and C4a anaphylatoxins were found in 59 patients with psoriasis. Remarkable increases in both C3a and C4a anaphylatoxins were also noted in some patients with leukocytoclastic vasculitis, urticarial vasculitis or unspecified toxic erythema. On the other hand, elevation of C4a alone was noted in a case of systemic lupus erythematosus. In contrast, using the mean of the normal control +/- 2 S.D., no significant anaphylatoxin elevation was found in 16 patients with pustulosis palmaris et plantaris, 7 with pityriasis rosea, 3 with erythema multiforme, and 3 with erythema nodosum or autoimmune bullous dermatoses.
