Complement Inhibition Decreases the Procoagulant Response and Confers Organ Protection in a Baboon Model of Escherichia Coli Sepsis

Blood. 2010 Aug 12;116(6):1002-10. doi: 10.1182/blood-2010-02-269746. Epub 2010 May 13.

Abstract

Severe sepsis leads to massive activation of coagulation and complement cascades that could contribute to multiple organ failure and death. To investigate the role of the complement and its crosstalk with the hemostatic system in the pathophysiology and therapeutics of sepsis, we have used a potent inhibitor (compstatin) administered early or late after Escherichia coli challenge in a baboon model of sepsis-induced multiple organ failure. Compstatin infusion inhibited sepsis-induced blood and tissue biomarkers of complement activation, reduced leucopenia and thrombocytopenia, and lowered the accumulation of macrophages and platelets in organs. Compstatin decreased the coagulopathic response by down-regulating tissue factor and PAI-1, diminished global blood coagulation markers (fibrinogen, fibrin-degradation products, APTT), and preserved the endothelial anticoagulant properties. Compstatin treatment also improved cardiac function and the biochemical markers of kidney and liver damage. Histologic analysis of vital organs collected from animals euthanized after 24 hours showed decreased microvascular thrombosis, improved vascular barrier function, and less leukocyte infiltration and cell death, all consistent with attenuated organ injury. We conclude that complement-coagulation interplay contributes to the progression of severe sepsis and blocking the harmful effects of complement activation products, especially during the organ failure stage of severe sepsis is a potentially important therapeutic strategy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Biomarkers / blood
  • Blood Coagulation / drug effects*
  • Blood Coagulation / immunology
  • Blood Pressure / drug effects
  • Complement Activation / drug effects
  • Complement Inactivator Proteins / metabolism
  • Complement Inactivator Proteins / pharmacology*
  • Cytokines / blood
  • Disease Models, Animal
  • Escherichia coli Infections* / blood
  • Escherichia coli Infections* / drug therapy
  • Escherichia coli Infections* / immunology
  • Multiple Organ Failure / blood
  • Multiple Organ Failure / immunology
  • Multiple Organ Failure / prevention & control*
  • Papio
  • Peptides, Cyclic / pharmacology*
  • Sepsis* / blood
  • Sepsis* / drug therapy
  • Sepsis* / immunology

Substances

  • Biomarkers
  • Complement Inactivator Proteins
  • Cytokines
  • Peptides, Cyclic
  • compstatin