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In vitro and in vivo studies have suggested that human complement component C5a plays a key role in neutrophil injury in the adult respiratory distress syndrome (ARDS). First, using leukocyte aggregometry, we demonstrated that the addition of a recently developed rabbit anti-human polyclonal antibody to C5a des arg to endotoxin-activated plasma prevented leukocyte aggregation in vitro. We then administered the anti-C5a des arg antibody to septic primates (Macaca fascicularis). Three groups of primates, coiltrol, septic, and anti-C5a antibody treated septic, were studied (n = 4 in each group). A 30-min infusion of Escherichia coii (1 X 101/kg) resulted in severe sepsis and ARDS. Primates were killed 4 h after completion of the E. coli infusion. Septic animals not treated with anti-C5a antibody had 75% mortality (3/4), decreased oxygenation, severe pulmonary edema, and profound hypotension. Septic primates treated with antiC5a antibodies did not die and did not develop decreased oxygenation (P < 0.05) or increased extravascular lung water (P < 0.05). They also had a marked recovery in their mean arterial blood pressure (P < 0.05). This study demonstrates that treatment with rabbit anti-human C5a des arg antibodies attenuates ARDS and some of the systemic manifestations of sepsis in nonhuman primates.

CHANGES IN THE GINGIVAL TISSUES during pregnancy have been termed "pregnancy gingivitis." During this period, the gingiva may appear hyperemic and enlarged and bleeding may be frequent during brushing or on external manipulation. Histopathologic evidence suggests that the microscopic changes observed in the gingiva during pregnancy do not differ from the microscopic changes observed in gingivitis in nonpregnant females. It is suggested that an accentuated inflammatory response to local irritants during pregnancy is the basic cause for the altered appearance of the gingival structures. Löe et al, in a cross-sectional study, examined 121 pregnant and 61 postpartum women. He reported that 100 percent of the women examined during pregnancy and postpartum demonstrated gingival changes which at the clinical level can be adequately described as inflammation of the gingiva (gingivitis), and that the severity of these changes were significantly higher in pregnant than in postpartum patients. The purpose of this investigation was to apply longitudinal epidemiologic techniques to:1. Measure the prevalence of periodontal disease during pregnancy and postpartum. Document the gingival and periodontal changesduring pregnancy and postpartum. 3. Determine what influence, if any, the gingival changes have on the underlying periodontium during pregnancy. 4. Document the presence of hard and soft irritants in the mouth during pregnancy and postpartum. 5. Determine what role local irritants play in the etiology of periodontal disease during pregnancy and postpartum.

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