After multiple trauma, development of systemic inflammatory response and innate immune dysfunction have been described, reflected by disturbances of the cellular defense and uncontrolled activation of the complement system. However, little is known about the complement function during the early posttraumatic period (< 90 min after accident). Therefore, we investigated the complement status and function in sera from trauma victims (n=40 with an injury severity score of ISS=35.2 „b 3.1), obtained at the scene, immediately after admission in the emergency room (ER), 4h, 12h, 24h and 120h and 240h after trauma. There was a robust complement activation at the scene with significantly enhanced levels of the complement activation products C3a, C5a and MAC. While the serum levels of C3a were consistently elevated over the 10 day observation period, C5a and MAC concentrations dropped over time after the initial peak. There was also a significant loss of chemotactic activity up to 4h after injury. Complement function was assessed by the hemolytic activity of serum (CH50). At the scene, CH50 activity was impaired and virtually abolished in the ER, indicating consumption of complement within the first hours after trauma. Furthermore, a positive correlation between the loss of hemolytic activity at the scene and the 10 day outcome was found. In conclusion, the complement‐associated defence seems to be compromised rapidly after severe trauma, which may lead to the enhanced susceptibility and impairment of the innate immune response after trauma.
This work was supported by NIH Grants No. GM‐61656, GM‐29507 and HL‐31963.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.