Skip to content

Advertisement

  • Poster presentation
  • Open Access

Compliment activity patterns in patients with sepsis after human purified C1-esterase inhibitor infusion

  • 1,
  • 1 and
  • 1
Critical Care200913 (Suppl 1) :P363

https://doi.org/10.1186/cc7527

  • Published:

Keywords

  • Complement Activity
  • Procalcitonin
  • Sepsis Patient
  • Baseline Result
  • Baseline Activity

Introduction

Our purpose was to assess the effects of super physiologic dosages of human purified C1-esterase inhibitor infusion (C1INH) on complement-dependent pathways of systemic inflammatory response in patients with sepsis.

Methods

In the terms of an open-label prospective control study, human purified C1INH (Bicizar; BioGenius LLC, Russia) was administered at total dosage of 12,000 U to 20 sepsis patients. Patients (n = 22) who did not receive C1INH infusion were enrolled as controls. C3 and C4 complement subunits, IL-6, C-reactive protein and procalcitonin results were analyzed in quartiles according to C1INH baseline activity.

Results

C1INH activity was different in quartiles at entry in both groups (P < 0.03). C1INH infusion resulted in elevation of C1INH activity in the treatment arm (Figure 1). The most significant difference was observed between the upper quartiles of the groups (P < 0.01). The degree of C1INH activity shift had a negative association with the baseline results (r = -0.635, P < 0.01). C3 (P < 0.01) and C4 (P < 0.05) levels displayed a more rapid and pronounced rise after C1INH infusion in patients with higher baseline C1INH activity. The C-reactive protein concentration dropped significantly in patients who received C1INH (130 mg/l (28 to 293)) already on the third day of the study in comparison with the control (185 mg/l (72 to 343); P = 0.022). The same trend characterized the IL-6 level. Patients with elevated procalcitonin values at the onset of sepsis had a more significant C1INH increase (r = 0.635, P < 0.05).
Figure 1
Figure 1

C1INH activity in the Bicizar (q) and control groups (c): analysis in quartiles.

Conclusion

Downregulation of complement activity with C1INH might help to contain severe systemic inflammation. Presumably, the response to C1INH infusion was related to its baseline activity.

Authors’ Affiliations

(1)
I.M. Sechenov Medical Academy, Moscow, Russian Federation

Copyright

© Igonin et al; licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd.

Advertisement