Complement system

81,341views

Complement system

A&D

A&D

Haemophilus influenzae
Mycobacterium tuberculosis (Tuberculosis)
Mycoplasma pneumoniae
Chlamydia trachomatis
Chlamydia pneumoniae
Treponema pallidum (Syphilis)
Epstein-Barr virus (Infectious mononucleosis)
Herpes simplex virus
Cytomegalovirus
Parvovirus B19
Human papillomavirus
Influenza virus
HIV (AIDS)
Candida
Cryptococcus neoformans
Pneumocystis jirovecii (Pneumocystis pneumonia)
Aspergillus fumigatus
Plasmodium species (Malaria)
Histoplasmosis
Blastomycosis
Coccidioidomycosis and paracoccidioidomycosis
Cell wall synthesis inhibitors: Penicillins
Cell wall synthesis inhibitors: Cephalosporins
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous protein synthesis inhibitors
Miscellaneous cell wall synthesis inhibitors
DNA synthesis inhibitors: Fluoroquinolones
Antimalarials
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Neuraminidase inhibitors
Nucleoside reverse transcriptase inhibitors (NRTIs)
Protease inhibitors
Herpesvirus medications
Integrase and entry inhibitors
Azoles
Echinocandins
Miscellaneous antifungal medications
Vitamin B12 deficiency
Iron deficiency anemia
Aplastic anemia
Anemia of chronic disease
Autoimmune hemolytic anemia
Macrocytic anemia: Pathology review
Microcytic anemia: Pathology review
Non-hemolytic normocytic anemia: Pathology review
Intrinsic hemolytic normocytic anemia: Pathology review
Anemia: Clinical
Sickle cell disease (NORD)
Sickle cell disease: Clinical
Alpha-thalassemia
Beta-thalassemia
Hereditary spherocytosis
Platelet plug formation (primary hemostasis)
Coagulation (secondary hemostasis)
Clot retraction and fibrinolysis
Hemolytic-uremic syndrome
Thrombotic thrombocytopenic purpura
Immune thrombocytopenia
Heparin-induced thrombocytopenia
Disseminated intravascular coagulation
Thrombocytopenia: Clinical
Von Willebrand disease
Platelet disorders: Pathology review
Coagulation disorders: Pathology review
Antiplatelet medications
Anticoagulants: Heparin
Anticoagulants: Direct factor inhibitors
Bleeding disorders: Clinical
Wiskott-Aldrich syndrome
Immunodeficiencies: Combined T-cell and B-cell disorders: Pathology review
Immunodeficiencies: Clinical
Hemophilia
B-cell development
B-cell activation, differentiation, and contraction
T-cell development
T-cell activation
Cell-mediated immunity of CD4 cells
Cell-mediated immunity of natural killer and CD8 cells
Thymic aplasia
Immunodeficiencies: Phagocyte and complement dysfunction: Pathology review
Adenosine deaminase deficiency
DiGeorge syndrome
Vaccinations: Clinical
Complement deficiency
Myasthenia gravis
Antibody classes
X-linked agammaglobulinemia
Type I hypersensitivity
Anaphylaxis
Type II hypersensitivity
Type III hypersensitivity
Type IV hypersensitivity
Graft-versus-host disease
Chronic granulomatous disease
Hyper IgM syndrome
Glucocorticoids
Non-corticosteroid immunosuppressants and immunotherapies
Introduction to the immune system
Innate immune system
Cytokines
Somatic hypermutation and affinity maturation
VDJ rearrangement
MHC class I and MHC class II molecules
Lymphomas: Pathology review
Non-Hodgkin lymphoma
Hodgkin lymphoma
Leukemias: Pathology review
Immunodeficiencies: T-cell and B-cell disorders: Pathology review
Plasma cell disorders: Pathology review
Complement system

Transcript

Watch video only

The complement system refers to a group of plasma proteins called the complement proteins, which are produced in the liver, and act collectively to help destroy pathogens. Think of them like a little militia that “complement” the work of antibodies.

There are actually three complement pathways: The classical pathway - called that because it was discovered first, the alternative pathway which was found second and is always at work, and the Lectin binding pathway - which was found third and when folks got more descriptive with their naming.

So let’s start with the proteins that make up the classical pathway - C1, C2, C3, C4, C5, C6, C7, C8, and C9. Pretty easy right?

Now these were numbered, in the order they were discovered, but not the order in which they function.

Generally speaking, each complement protein is normally inactive, and it becomes activated when it’s cleaved - in other words when some part of it breaks free. A bit like how a fire extinguisher isn’t “active” until a pin is pulled out.

Now in the classical pathway things start out with C1.

C1 has three component C1q, C1r, and C1s.

It has six C1q subunits, which are able to bind to the Fc portion of an antibody when it is bound to antigen.

Each C1q can bind to 1 antibody-antigen complex, so technically each C1 molecule can bind 6 antibodies.

Both the C1r and C1s subunits are both enzymes called serine proteases.

C1q has zero enzymatic activity and typically the serine proteases C1s and C1r are hidden so they cannot perform their enzymatic activity.

This is all tied together in a calcium bow, so when there is a lack of calcium, C1 is also lacking.

When 2 or more of the C1q portions bind to the Fc receptors of 2 or more antibodies that are bound to antigen it causes a conformational change of the C1 molecule which twists, exposing the C1s and C1r serine protease sites. A bit like taking the safety cover off of a pair of scissors.

This allows C1r to to cleave C1s activating the C1 molecule.

The activated C1 cleaves C4 into C4a and C4b.

C4a floats away, but C4b binds to the surface of the pathogen.

C1 also cleaves C2 into C2a and C2b.

This time, C2a floats away and C2b joins C4b on the surface of the pathogen forming a protein complex called C4b2b or C3 convertase.

C3 convertase cleaves C3 into C3a and C3b.

Now this is the step that really amplifies things. That’s because a single C1 can generate maybe 10 C3 convertases, but a single C3 convertase can cleave over a 1000 C3 proteins per second, and this enzyme stays active for about 2 minutes, so you’ll get a lot of C3b very quickly.

C3b is also called opsonin, and in general opsonins are terrific because they help phagocytes get a firm grip on bacteria.

Normally, bacteria have an antiphagocytic capsule which makes them slippery and hard to grab.

Opsonization is the process by which pathogens are coated with molecules so that they can be more easily picked up by phagocytes.

Imagine trying to pick up a slippery meatball with your fingers versus stabbing it with a fork and then just having to pick up the fork.

Opsonization also makes it easier to eat meatballs faster too. In this case, C3b is serving as that fork!

Once there’s a certain amount of C3b made, some of the C3b proteins come and bind really close to the C4b2b or C3 convertase, and turn it into a C4b2b3b protein complex which is called C5 convertase.

The C5 convertase cleaves C5 into C5a and C5b.

C5b binds to C6, C7, and C8 and together these four proteins begin to penetrate through the pathogen’s cell membrane.

They’re joined by small groups of C9 proteins which help form a channel straight thru the membrane the pathogen.

Key Takeaways

The complement system is a group of proteins that help the body fight infection. The complement system has three pathways: classical, alternative, and lectin pathways. The classical pathway is activated by antibodies, and the alternative and lectin pathways are activated by molecules called pathogen-associated molecular patterns (PAMPs).

The complement system can kill bacteria, viruses, or other cells damaged or invaded by pathogens. They also promote inflammation, which helps activate the immune system even further, and clear away pathogens and debris.