The Complement System

1. The Complement System

2. Historical Background • Pfeiffer:- Lysis of Cholera bacilli - Demonstration of heat liability • Bordet: Confirmed the observations and called the substance Alexine • Ehrlich: Introduced the term Complement

3. Introduction • The complement system consists of a group of serum proteins that act in concert and in an orderly sequence to exert their effect • These proteins are not immunoglobulins and their concentrations in serum do not increase after immunization • Complement activation (fixation) leads to lysis of cells and to the generation of many powerful biologically active substances

4. Complement Activation Pathways • The Classical Pathway - Ag- Ab complexes • The Alternative Pathway - Aggregated immunoglobulins and microbial products • The Mannan - Binding Lectin Pathway - Microbial products

6. The Classical Pathway-1 • Activators: Ag – Ab complexes • Antibodies involved: IgG and IgM • Activation in an orderly fashion of nine major protein components; C1 – C9 • Products of activation are enzymes that catalyze the subsequent step

7. The Classical Pathway-2 • Activation of C1: • C1 consists of C1q (400.000 Daltons), C1r (95000 Daltons), and C1s (85000 Daltons) • Subunits are held together by Calcium ions • C1q is a polymer of 6 identical units • C1q activation requires binding to a c1q- specific receptor on the FC region of at least 2 adjacent molecules of IgG or a single molecule of IgM, a reaction that requires Calcium ions

9. Molecular structure of C1

10. IgG has only two sites per molecule. In order to achieve effective C1q binding and complement activation two IgG molecules must bind close to each other

12. IgA and IgE cannot activate complement

13. The Classical Pathway-3 • IgG4, IgA, and IgE do not have complement receptors • Activated C1q activates C1r which in turn activates C1s • Activated C1s has esterolytic and proteolytic properties which acts on C4 splitting it into two fragments; C4a and C4b • C4b complexes with C1s forming an active component that acts on C2 splitting it into C2a and C2b • C2b binds to C4b creating a very active complex called the C3 convertase, where a single molecule can activate hundreds of C3 molecules

14. The Classical Pathway-4 • C3 is split by C4b2b into C3a and C3b • C3b binds to cells and to C4b2b to generate C5 convertase which splits C5 into C5a and C5b • C5b binds to cells and activates C6 and C7 • The complex C5b67 activates C8 and C9 forming a giant molecule with a molecular weight of 106 Daltonscalled the membrane attack complex (MAC)

16. The Classical Pathway-5 • C5b6789 bound to cells insert themselves into the cell membrane and produce transmembrane channels allowing ions to pass through • The osmotic equilibrium of the cell is disturbed with rapid influx of water into the cell which swells and lyses

17. C4b2b C1s C1s C3 C3a + C3b C2 C2a + C2b C4 C4a + C4b C4b and C2b combine to form C4b2b C4b2b is a C3 convertase (there are others) C3b binds to C4b2b to form C4b2b3b which is a C5 convertase which cleaves C5 into C5a and C5b. C5b C5b6 C5b67 C5b678 C5b678(9)n

18. The Alternative (properdin) Pathway-1 • Activators: Bacterial LPS, cell wall of some bacteria, some yeast cells, aggregated IgA, and a factor present in cobra venom • Components: C3 – C9, factor B, factor D, and Properdin • C3b present in trace amounts in serum combines with factor B forming C3bB

19. The Alternative (properdin) Pathway-2 • C3bB is further activated by serum factor D which cleaves factor B into Ba and Bb generating C3bBb • C3bBb has a C3 convertase activity splitting C3 into C3a and C3b • C3b binds to Bb amplifying the loop of activation • Properdin acts to stabilize C3bBb in the form of C(3b)nBb

23. The Mannan Binding Lectin (MBL)-1 • Activators: microorganisms and foreign invaders • Components: C2 – C9, MASP • MBL recognizes carbohydrate structures through its carbohydrate – recognizing domain (CRD) and then it can interact with an enzyme called MBL – activated serine protease (MASP)

24. The Mannan Binding Lectin (MBL)-2 • Activation of MASP leads to enzymatic activation of sequential complement components • The MBL/ MASP complex cleaves C4 into C4a and C4b and it also cleaves C2 into C2a and C2b creating C3 convertase which cleaves C3 into C3a and C3b • The sequence of events then proceeds as for the classical and alternative pathways

26. Products of C3 cleavage Adjuvant

27. Receptors for Complement Proteins

28. General Functions of Complement

29. Complement functions related to immune defense • Lysis of cells: This is the original function identified and causes hypotonic cell death by making holes. It is not effective against organisms with rigid cell walls such as fungi and Gram positive bacteria • Opsonization: Antigen coated with C3b binds to cells bearing complement receptors and if the cell is a phagocyte the antigen will be phagocytosed.

30. Terminal complement components and the formation of the membrane attack complex

31. C5a 70-100 Å C5b The Membrane Attack Complex C5 C9 C9 C9 C9 C9 C9 C9 C9 C9 C9 C9 C7 C8 C6

32. The contents of the cell leak out through the MAC pore and the cell dies Before complement After complement treatment

33. Inflammation: -The anaphylatoxins, C5a, C3a, and C4a of which C5a is the most potent bind receptors on mast cells and basophils and cause degranulation with the release of pharmacologically active mediators which induce smooth-muscle contraction and increases in vascular permeability. - Chemoattractants:C3a, C5a and C5b67 attract and induce monocytes and neutrophils to adhere to vascular endothelial cells, extravasate through the endothelial lining of the capillaries and migrate to the site of complement activation in the tissue.

34. Immune clearance: Removes immune complexes from the circulation and deposits them in the liver where they are degraded. • Enhanced immune response: CD21, part of the co-receptor on the B cell, binds cleaved C3. Recently it has also been shown that C3 is required for optimal expansion of T cells during a systemic viral infection. • Virus neutralization: Complement mediates viral neutralization by facilitating viral aggregation and by coating the viral surface.

35. (anaphylotoxins)

37. Regulation of the Complement Cascade Short half-time of C3b C3bBb C5b C1 inhibitor Inhibits the C1s activity Protein S in Serum Binds to C5b67 Inhibits Formation of the Membrane Attack Complex

38. HRF or CD59 Bind to C8 Inhibits C9 binding Factor H Binds to C3b Facilitates binding of Factor I cleaves C3b to inactive iC3b cleaves C4b to inactive fragments Decay Accelerating Factor or CD56 Increased dissociation of C3 convertase (both pathways)

42. Complement Abnormalities • Hereditary Angioneurotic Edema (C1INH Deficiency) • Component Deficiencies: Any component may be affected, most important of which is C3 deficiency which predisposes to infection by Neisseria meningitidis and Neisseriagonorrhea

43. The Complement Fixation Test • Antibody (lysin), antigen, complement, and sensitized sheep RBCs are required • Complement is fixed to a Ab - Ag-complex • Fixed complement cannot participate in RBC lysis = positive reaction or identification

44. Complement fixation test 44