Complement and meningococcal infection.

Greenwood, Brian; Onyewotu, I I; Whittle, H.C.

doi:10.1136/bmj.1.6013.797

Cited by 52 publications

(15 citation statements)

References 10 publications

(2 reference statements)

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“…Epidemics of group A disease in Africa are known to occur during the season when the Harmattan winds are blowing dust off the Sahara and when absolute humidity is very low [18]. No similar climatic conditions occur in Europe, although associations with dust exposure at new building sites have been observed in Norway and Spain (Dr T. Gedde-Dahl, pers.…”

Section: Exposure To Dustmentioning

confidence: 99%

“…Low socioeconomic status [13,15], mental and physical stress, preceding influenza A and other upper respiratory infections, and damp living conditions [13,14,16,17] have all been associated with MD. The incidence of disease is higher in the winter in Europe and North America, while the epidemics of sub-Saharan Africa occur during the hot dry months [18].…”

Section: Introductionmentioning

confidence: 99%

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Smoking, the environment and meningococcal disease: a case control study

Stuart²,

et al. 1994

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SUMMARYThis case control study investigated environmental factors in 74 confirmed cases of meningococcal disease (MD). In children aged under 5, passive smoking in the home (30 or more cigarettes daily) was associated with an odds ratio (OR) of 7 5 (95% confidence interval (CI) 1P46-38-66). ORs increased both with the numbers of cigarettes smoked and with the number of smokers in the household, suggesting a dose-response relationship. MD in this age group was also significantly associated with household overcrowding (more than 1P5 persons per room) (OR 60, 95% CI 110-32-8), with kisses on the mouth with 4 or more contacts in the previous 2 weeks (OR 2-46, 95% CI 1P09-5 56), with exposure to dust from plaster, brick or stone in the previous 2 weeks (OR 2-24, 95 % CI 107-465); and with changes in residence (OR 30, 95% CI 1P0-899), marital arguments (OR 3-0, 95 % CI 1P26-7 17) and legal disputes in the previous 6 months (OR 3-10, 95% CI 1P24-7 78). These associations were independent of social class. Public health measures to lower the prevalence of cigarette smoking by parents of young children may reduce the incidence of MD. The influence of building dust and stressful life events merits further investigation.

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Section: Exposure To Dustmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Smoking, the environment and meningococcal disease: a case control study

Stuart²,

et al. 1994

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“…Clinical studies have demonstrated a direct correlation between the presence of capsular polysaccharide in serum and the degree of complement consumption (21,137,159,392). Recent 354,380,381).…”

Section: Infection In Complement Deficiency States Epidemiologymentioning

confidence: 99%

Infectious diseases associated with complement deficiencies

1991

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The complement system consists of both plasma and membrane proteins. The former influence the inflammatory response, immune modulation, and host defense. The latter are complement receptors, which mediate the cellular effects of complement activation, and regulatory proteins, which protect host cells from complement-mediated injury. Complement activation occurs via either the classical or the alternative pathway, which converge at the level of C3 and share a sequence of terminal components. Four aspects of the complement cascade are critical to its function and regulation: (i) activation of the classical pathway, (ii) activation of the alternative pathway, (iii) C3 convertase formation and C3 deposition, and (iv) membrane attack complex assembly and insertion. In general, mechanisms evolved by pathogenic microbes to resist the effects of complement are targeted to these four steps. Because individual complement proteins subserve unique functional activities and are activated in a sequential manner, complement deficiency states are associated with predictable defects in complement-dependent functions. These deficiency states can be grouped by which of the above four mechanisms they disrupt. They are distinguished by unique epidemiologic, clinical, and microbiologic features and are most prevalent in patients with certain rheumatologic and infectious diseases. Ethnic background and the incidence of infection are important cofactors determining this prevalence. Although complement undoubtedly plays a role in host defense against many microbial pathogens, it appears most important in protection against encapsulated bacteria, especially Neisseria meningitidis but also Streptococcus pneumoniae, Haemophilus influenzae, and, to a lesser extent, Neisseria gonorrhoeae. The availability of effective polysaccharide vaccines and antibiotics provides an immunologic and chemotherapeutic rationale for preventing and treating infection in patients with these deficiencies.

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“…Early in a meningococcal infection there may be free circulating meningococcal antigens, but secondary features develop later when the corresponding antibody concentrations rise, coinciding with a fall in complement levels (Greenwood, Onyewotu and Whittle, 1976). Immune complexes have been found at this time both in serum (Davis et al, 1976) and in synovial fluid from affected joints (Larson et al, 1977).…”

Section: Commentmentioning

confidence: 99%