Complement Activity in Pneumonia 1

Abstract

In the evaluation of the immunity mechanism in man during pneumococcus pneumonia, complement studies have received little attention. Publications concerning the level of antibody in relation to recovery from pneumonia have been summarized up to 1939 by Heffron (1), and other studies have been published since that time (2 to 6). The few studies regarding complement activity in pneumonia which have been published present conflicting conclusions. Dick (7) studied 4 pneumonia patients and 2 controls and reported that complement activity increased during pneumonia and returned to normal after crisis. Veil and Buchholz (8) stated that complement activity did not decrease during pneumonia but presented no data. Robertson, Sia, and Cornwell (9) reported without specific data that "little evidence was obtained to show that the activating effect of fresh animal (including human) serum undergoes any significant alteration during the disease." Taplin (10) noted that 6 patients who failed to respond to adequate and specific serum therapy were found to be deficient in serum complement. Dingle (11) studied 73 patients with many diseases, 9 of whom had pneumonia. Only 2 of the 73 patients had diminished complement activity, and both of these were pneumonia patients.It has been demonstrated in vitro by Robertson, Sia, and Cornwell (9) that the addition of fresh normal serum increased the pneumococcidal-promoting action of Type I antipneumococcus serum, and Ward and Enders (12) paratively narrow range. These findings, particularly those of Taplin, suggested the need for further study of complement activity in pneumonia.Accordingly, complement activity was studied in the blood serum of 75 patients admitted to the Albany Hospital from February 1940 to June 1941 for the treatment of pneumococcus pneumonia. This report presents the observations of that study with particular reference to outcome, pneumococcus type, bacteremia, serum administration, drug administration and serum sickness, although not every case was included in each series.The diagnosis of pneumonia was confirmed in every case by an x-ray photograph of the chest and by demonstration of type-specific pneumococci on direct examination of the sputum (Neufeld). METHODSBlood specimens were collected, allowed to clot, centrifuged, and the sera pipetted off in the usual fashion. Sterile dry equipment was used throughout. The specimens were numbered and allowed to stand at refrigerator temperature overnight. They were then transferred, without any accompanying information other than the name of the patient and the date of bleeding, to the laboratory of Dr. Frank Maltaner 2 at the Division of Laboratories and Research of the New York State Department of Health. Specimens were kept at refrigerator temperature from the time of separation of the serum up to the time of testing, with the exception of the time required for transfer of the specimens to the laboratory. The distance between the hospital and the laboratory is but a few hundred yards, and it is believed that no apprecia...

Classical and alternative complement pathway activation by pneumococci

“…Complement depletion has been shown to occur frequently in pneumococcal pneumonia (20), especially just before death (23). In one series properdin levels were depressed in over half of the cases of pneumococcal pneumonia (8).…”

Experimental Hypersensitivity in the Rabbit

“…As part of these experiments a study was made of the behavior of serum complement in rabbits after the injection of foreign protein, because of the depression of hemolytic complement activity known to occur in anaphylaxis in guinea pigs (3) and often in human serum sickness (4).…”

Experimental Study of Diphtheritic Polyneuritis in the Rabbit and Guinea Pig

“…Circulating granulocyte and lymphocyte counts were reduced sufficiently by the dose of x-ray to interfere seriously with the expression of either Arthus or delayed types of sensitivity had they been present. There was no fall in the level of circulating complement comparable to that which occurs in serum disease (31,42). Indeed, the total protein injected in the rabbits in these experiments was less than that required to produce serum disease by a factor of approximately 107.…”