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Citation
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Satyam A, Andreo K, Lapchak PH, Dalle Lucca JJ, Davis RB, Tsokos MG, Shapiro NI, Tsokos GC. Shock 2019; ePub(ePub): ePub. |
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Affiliation
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Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. |
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Abstract
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BACKGROUND: Activation of the complement system and complement deposition on red blood cells (RBCs) contribute to organ damage in trauma. We conducted a prospective study in subjects with traumatic injuries to determine the pattern of complement deposition on RBC and whether they are associated with clinical outcomes.
METHOD: A total of 124 trauma patients and 42 healthy controls were enrolled in this prospective study. RBC and sera were collected at 0, 6, 24 and 72 hours from trauma patients and healthy controls during a single draw. Presence of C4d, C3d, C5b-9, phosphorylation of band 3 and production of nitric oxide were analyzed by flow cytometry.
RESULTS: RBC from trauma patients at all time points up to 24 hours displayed significantly higher deposition of C4d on their RBC membrane as compared to healthy donors. Incubation of normal RBC with sera from trauma patients resulted in significant increase of C4d deposition (at 0, 6, 24 and 72 hours), C5b-9 deposition (at 0 and 6 hours), phosphorylation of band 3 (at 0 and 24 hours), and nitric oxide (NO) production up to 24 hours compared to sera from healthy subjects. Deposition of C4d and C5b-9 in patients with an ISS of 9 and above remained elevated up to 72 hours.
CONCLUSIONS: Our study demonstrates that the presence of C4d, C3d, and C5b-9 on the surface of RBC is linked to increased phosphorylation of band 3 and increased production of nitric oxide. Deposition of C4d and C5b-9 decreased faster over course of 3-day study in subjects with ISS less than 9.
Language: en |