Complement activation in the central nervous system following blood–brain barrier damage in man

PJ Lindsberg, J Öhman, T Lehto… - Annals of Neurology …, 1996 - Wiley Online Library
PJ Lindsberg, J Öhman, T Lehto, T Wuorimaa, S Meri, ML Karjalainen‐Lindsberg, A Paetau…
Annals of Neurology: Official Journal of the American Neurological …, 1996Wiley Online Library
The central nervous system (CNS) is virtually isolated from circulating immunological factors
such as complment (C), an important mediator of humoral immunity and inflammation. In
circulation, C i constantly inhibited to prevent attack on host cells. Since a host of diseases
produce an abnormal blood–brain/cerebrospinal fluid (blood–brain/CSF) permeability
allowing C protein extravasation, we investigated if C activation occurs in CSF in vitro and in
CNS in vivo during subarachnoid hermorrhage (SAH) or brain infrarction. After SAH (n= 15) …
Abstract
The central nervous system (CNS) is virtually isolated from circulating immunological factors such as complment (C), an important mediator of humoral immunity and inflammation. In circulation, C i constantly inhibited to prevent attack on host cells. Since a host of diseases produce an abnormal blood–brain/cerebrospinal fluid (blood–brain/CSF) permeability allowing C protein extravasation, we investigated if C activation occurs in CSF in vitro and in CNS in vivo during subarachnoid hermorrhage (SAH) or brain infrarction. After SAH (n = 15), the terminal complement complex (TCC) concentration on days 0 to 2 was higher in the CSF, 210 ± 61 ng/ml, than in the plasma 63 ± 17 ng/ml, but null in the CSF of controls (n = 8) or patients with an ischemic stroke (n = 7). TCC was eliminated from the CSF after SAH (24 ± 10 ng/ml on days 7 to 10) Incubation of normal human CSF with serum in vitro also activated the terminal C pathway. In 10 fatal ischmemic brain infrarctions, immunohistochemical techniques demonstrated neuronal fragment‐associated deposition of C9 accompanied by neutrophil infiltration. We conclude that the C system becomes activated intrathecally in SAH and focally in the brain parenchyma in ischemic stroke. By promoting chemotaxis and vascular perturbation, C activation may instigate nonimmune inflammation and aggravate CNS damage in diseases associated with plasma extravasation.
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