COMPLEMENT ACTIVATION IN PATIENTS WITH SEPSIS IS IN PART MEDIATED BY C-REACTIVE PROTEIN

The involvement of C-reactive protein (CRP) in the activation of compl ement in patients with sepsis was investigated, In 104 patients with i nfections of varying severity, circulating levels of CRP-complement co mplexes, which are specific indicators for CRP-mediated complement act ivation, were assessed. Complement-CRP complexes were increased in alm ost all patients and correlated significantly with levels of C3a (r = .59; P < .001) and C-reactive protein (r = .76; P < .001). In addition , they correlated with levels of secretory phospholipase Az (r = .59; P < .001). Levels of complement-CRP complexes in patients with a pneum ococcal type of infection were similar to those in patients with other types of infections. Complement-CRP complexes were significantly high er in patients with shock (P = .01) and in patients who died (P = .03) . These results demonstrate that part of the complement activation in patients with sepsis is independent from a direct interaction with mic roorganisms but rather results from an endogenous mechanism involving CRP.