Perioperative Effect of Methylprednisolone Given During Lung Surgery on Plasma Concentrations of C3a and C5a

Mikawa, Katsuya; Ikegaki, Junichi; Maekawa, Nobuhiro; Hoshina, H.; Tanaka, Osamu; Goto, Ryokichi; Obara, Hidefumi; Kusunoki, Masato

doi:10.3109/14017439009098074

Cited by 10 publications

(12 citation statements)

References 22 publications

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“…In the current study, we found that the basal values before induction of anaesthesia were comparable to those of adults reported by many researchers (Heideman, Keijser & Gelin 1978;Hallgren, Samuelsson & Modig 1987;Bengtsson et al 1987;Mikawa et al 1990). Activation of the complement system, which is associated with the consumption of serum complement components and the liberation of complement split products, can be determined by measuring the presence of C3a and C5a.…”

Section: Discussionsupporting

confidence: 90%

Peri‐operative changes in plasma C3a and C5a concentrations in infants

Mikawa

Maekawa

Ikegaki

et al. 1992

Pediatric Anesthesia

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Summa yIt is well known that complement activation plays a key role in the development of pulmonary insufficiency; it is also well known that cortisol suppresses complement activation. By measuring the plasma concentrations of C3a and C5a, we investigated peri-operative changes in the activation of the complement system in 18 infants undergoing elective abdominal surgery. We also measured plasma cortisol concentrations to assess the peri-operative relationship between complement activation and the stress produced by multiple perioperative factors following two anaesthetic techniques. Eighteen infants ranging in age from 1 to 11 months were randomly divided into two groups according to the anaesthetic technique used: Group 1 consisted of nine infants in whom general anaesthesia was maintained with halothane and nitrous oxide (N20) in oxygen, while Group 2 consisted of nine infants in whom general anaesthesia was maintained with fentanyl and N 2 0 in oxygen. Plasma C3a and C5a concentrations were higher in the fentanyl group than in the halothane group during the peri-operative period. Plasma cortisol concentration, in contrast, was lower in the fentanyl group both during and after surgery. The post-operative clinical course showed no significant intergroup differences between the two groups throughout the study. These observations suggest that the difference in peri-operative complement activation between the halothane and the fentanyl groups may have been due, in part, to different peri-operative stress responses. However, further studies are required to elucidate the precise causative mechanisms and the clinical implications of complement activation in infants.

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Section: Discussionsupporting

confidence: 90%

Peri‐operative changes in plasma C3a and C5a concentrations in infants

Mikawa

Maekawa

Ikegaki

et al. 1992

Pediatric Anesthesia

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“…Miyano et al reported that the C3a activation system seemed to be well developed even before week 25 of gestation (14). In the current study, basal values in neonates before induction of anaesthesia were comparable to those demonstrated in adults by many researchers (2,(15)(16)(17). C3 is the common meeting point of the two pathways: the classical and the alternative.…”

Section: Discussionsupporting

confidence: 87%

Perioperative complement activation in neonates under halothane or fentanyl anaesthesia

Mikawa

Maekawa

Goto

et al. 1992

Acta Anaesthesiol Scand

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We investigated perioperative changes in complement activation in 18 neonates undergoing elective abdominal surgery with or without thoracotomy by measuring plasma concentrations of C3a and C5a, and leucocyte counts in peripheral blood. The 18 neonates, ranging in age from 1 to 17 days, were randomly divided into two groups according to type of anaesthetic procedures; the "halothane group" consisted of nine neonates in whom general anaesthesia was maintained with halothane and nitrous oxide (N2O) in oxygen, while the "fentanyl group" consisted of nine neonates in whom general anaesthesia was maintained with fentanyl and N2O in oxygen. Plasma C3a and C5a concentrations were higher in the fentanyl group than in the halothane group during the perioperative period. We have demonstrated that abdominal surgical trauma caused complement activation even in neonates undergoing the fentanyl rather than the halothane anaesthesia. Further studies are required to elucidate the precise mechanisms and the clinical implication of perioperative complement activation in neonates.

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“…In comparison, our cohort included patients with new‐onset and relapsing disease who may have received immunosuppressive treatment (except rituximab or plasma exchange) at the time of sample procurement. There is evidence that glucocorticoids quickly reduce complement activation . In our cohort, 26% of patients with active disease were receiving glucocorticoids and 48% were receiving steroid‐sparing immunosuppressants when the sample was obtained.…”

Section: Discussionmentioning

confidence: 94%

Measuring Circulating Complement Activation Products in Myeloperoxidase– and Proteinase 3–Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

McInnis

Boyer‐Suavet

et al. 2019

Arthritis & Rheumatology

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Objective There is accumulating evidence that complement activation is important in antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) pathogenesis. This study was undertaken to investigate complement activation in AAV with myeloperoxidase (MPO) positivity and AAV with proteinase 3 (PR3) positivity after determining optimal methods for measuring activated complement factors in circulation. Methods Participants included 98 patients with AAV (45 MPO‐ANCA positive, 53 PR3‐ANCA positive) and 35 healthy controls. Plasma was obtained from blood collected using EDTA tubes, with or without 100 μg/ml Futhan. Levels of Bb, C3a, C5a, soluble C5b–9 (sC5b–9), properdin, and C4d were measured by enzyme‐linked immunosorbent assay. Group comparisons were made using Wilcoxon's 2‐sample test. Paired data were analyzed using a matched pairs signed rank test. Results Compared to healthy controls, certain complement analyte levels were high in patients with active AAV with MPO positivity, including C3a (P < 0.0001), C5a (P = 0.0004), and sC5b–9 (P = 0.0007). During remission, levels of Bb (P = 0.001), C3a (P < 0.0001), and sC5b–9 (P = 0.003) were higher. Compared to healthy controls, C3a (P < 0.0001), C5a (P = 0.002), sC5b–9 (P = 0.0001), and C4d (P = 0.005) levels were higher in patients with active AAV with PR3 positivity; levels of C3a (P < 0.0001) and C4d (P = 0.007) were also higher duriing remission. There were no significant differences in any complement analyte for either ANCA serotype between patients with active disease and those with disease in remission. Among patients with paired samples, sC5‐9 levels were significantly lower during disease remission compared to active disease. C5a was significantly lower among patients with disease in long‐term remission who were not receiving therapy. For Bb, C5a, and sC5b–9, median levels and individual values were considerably higher in control and patient samples processed without Futhan compared to those processed with Futhan. Conclusion Complement activation occurs in both MPO‐positive AAV and PR3‐positive AAV. The complement activation profile differs according to disease activity and possibly ANCA serotype. Futhan reduces in vitro complement activation and provides a more accurate measurement.

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Perioperative Effect of Methylprednisolone Given During Lung Surgery on Plasma Concentrations of C3a and C5a

Cited by 10 publications

References 22 publications

Peri‐operative changes in plasma C3a and C5a concentrations in infants

Peri‐operative changes in plasma C3a and C5a concentrations in infants

Perioperative complement activation in neonates under halothane or fentanyl anaesthesia

Measuring Circulating Complement Activation Products in Myeloperoxidase– and Proteinase 3–Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

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