Blood complement system

Plasma Inhibitors, In Vivo Anticoagulants. Fourteen naturally occurring compounds that normally exert an inhibiting effect on the activity of coagulation, platelet function, and fibrinolytic activity and complement systems have been identified within the circulating blood. 

The complement system resembles blood coagulation (Chapter 51) in that it involves both conversion of... 

The complement system comprises twenty plasma proteins present in the blood and in most bodily fluids. They are normally present in an inactive form but become activated via two separate pathways the classical pathway, which requires antibody, and the alternative pathway, which does not. Once the initial components of complement are activated, a cascade reac-... 

The complement system which functions as part of the immune response is composed of about twenty proteins which circulate in the blood stream as inactive precursors. The complement cascade is functionally divided into two arms called the classical and alternative pathways, reflecting their different initiating events but which converge at C3. A simplified scheme is shown in Figure 5.25. 

The table also lists important globulins in blood plasma, with their mass and function. The a- and p-globulins are involved in the transport of lipids (lipoproteins see p. 278), hormones, vitamins, and metal ions. In addition, they provide coagulation factors, protease inhibitors, and the proteins of the complement system (see p. 298). Soluble antibodies (immunoglobulins see p. 300) make up the y-globulin fraction. 

If blood from blood group A is transfused into the circulation of an individual with blood group B, for example, then the anti-A present there binds to the A antigens. The donor erythrocytes marked in this way are recognized and destroyed by the complement system (see p. 298). In the test tube, agglutination of the erythrocytes can be observed when donor and recipient blood are incompatible. 

The complement system is part of the innate immune system (see p. 294). It supports nonspecific defense against microorganisms. The system consists of some 30 different proteins, the "complement factors," which are found in the blood and represent about 4% of all plasma proteins there. When inflammatory reactions occur, the complement factors enter the infected tissue and take effect there. 

As in blood coagulation (see p. 290), the early components in the complement system are serine proteinoses, which mutually activate each other through limited proteolysis. They create a self-reinforcing enzyme cascade. Factor C3, the products of which are involved in several functions, is central to the complement system. 

There are thus various autoantibodies present, and if the auto-antigens are released by cellular breakdown, a type III immune reaction can occur where an immune complex is formed, which is deposited in small blood vessels and joints, giving rise to many of the symptoms. The immunoglobulins IgG and IgE act as both autoantibody and antigen, and hence immune complexes form. Such complexes stimulate the complement system leading to inflammation, infiltration by polymorphs and macrophages, and the release of lysosomal enzymes. 

Immunoglobulins, oq-trypsin inhibitor and a2-macroglobulin,k ten or more blood clotting factors and proteins of the complement system all have protective functions that are discussed elsewhere in this book. Hormones, many of them proteins, are present in the blood as they are carried to their target tissues. Many serum proteins have unknown or poorly understood functions. Among these are the acute phase proteins, whose concentrations rise in response to inflammation or other injury. 

Collagen-like triple helices also occur within other proteins. One of these is protein Clq, a component of the complement system of blood (Chapter 31). This protein interacts with antibodies to trigger a major aspect of the immune response. Clq has six subunits, each made up of three different polypeptide chains of about 200 residues apiece. Beginning a few residues from the N termini, there are over 80 residues in each chain with collagen-like sequences. The three chains apparently form a triple helix within each subunit. However, the C-terminal portions are globular in nature.200 Collagen-like tails also are present on some forms of the enzyme acetylcholinesterase (see Chapter 12C,10). Tire extensins of plant cell walls contain 4-hydroxyproline and evidently have a structure... 

Channel-forming toxins and antibiotics. Some of the bacterial toxins known as colicins (Box 8-D) kill susceptible bacteria by creating pores that allow K+ to leak out of the cells. One part of the complement system of blood (Chapter 31) uses specific proteins to literally punch holes in foreign cell membranes. Mel-litin, a 26-residue peptide of bee venom,372 373 as well as other hemolytic toxins and antibiotic peptides of insects, amphibians, and mammals (Chapter 31) form amphip-athic helices which associate to form voltage-dependent anion-selective channels in membranes.374-377... 

Elaborate cascades initiate the clotting of blood (Chapter 12) and the action of the protective complement system (Chapter 31). Cascades considered later in the book are involved in controlling transcription (Fig. 11-13) and in the regulation of mammalian pyruvate dehydrogenase (Eq. 17-9), 3-hydroxy-3-methyl-glutaryl-CoA reductase and eicosanoids (Chapter 21), and glutamine synthetase (Chapter 24). 

Cascade systems also provide for response to more than one allosteric stimulus in a single pathway. Thus, as shown in Fig. 11-4, glycogen catabolism can be initiated in more than one way. Two pathways are known for initiation of both blood clotting and activation of the complement system. Many pathways activate the MAP kinase pathway shown in Fig. 11-13. 

Every regulatory system in the body must be prevented from overactivity or activity that is unnecessarily prolonged. This can help us understand that, just as with blood clotting (Fig. 12-17), a network of regulatory factors controls the complement system. Among these are an inhibitory C4b-binding protein (C4BP),181 which acts to prevent excessive formation of the C4b C2a complex (Fig. 31-8). Complement cofactor I is a serine protease that cleaves both C3b and C4b into smaller pieces in the presence of cofactor... 

About 20 different proteins are included in the complement system Proteins C1-C9, factors B and D, and a series of regulatory proteins. All these proteins are made in the liver, and they circulate freely in the blood and extracellular fluid. Activation of the complement system involves a cascade of proteolytic reactions. In addition to forming membrane attack complexes, the proteolytic fragments released during the activation process promote dilation of blood vessels and the accumulation of phagocytes at the site of infection. 

The complement system consists of about 20 interacting soluble proteins that circulate in the blood and extracellular fluid. Immunoglobulin molecules bound to the surface of the microorganisms activate Cl, the first component of the complement pathway. The activation occurs through the Fc portion (see Topic D2) of the bound antibody. Only bound antibody can activate complement, soluble antibody not bound to an antigen has no such effect. 

The serine proteases are a dass of proteolytic enzyme (they catalyze the hydrolysis of either ester or peptide bonds in proteins) that require an active site residue for covalent catalysis. The active site residue, the catalytic Ser-195, is particularly activated by hydrogen-bonding interactions with His-57 and Asp-102. Crystal structures show that Ser-195, His-57, and Asp-102 are dose in space. Together these three residues, which are located in the substrate binding (SI) pocket, form the famed catalytic triad of the serine proteases. In humans and mammals serine proteases perform many important functions, especially the digestion of dietary protein, in the blood-dotting cascade, and in the complement system ... 

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