18 - The Complement System Flashcards

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1
Q

The complement system provides protection…

a) throughout infection
b) early on in infection
c) during later stages of infection
d) against reccurrent infection

A

The complement system provides protection…

a) throughout infection

b) early on in infection

c) during later stages of infection
d) against reccurrent infection

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2
Q

The complement system link both innate and adaptive immune responses. It is a major branch of which part of the immune system?

A

Humoral

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3
Q

The complement system can be described as a…

A

A series of proteins which make up a highly regulated enzymatic cascade leading to antigen clearance and inflammatory response.

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4
Q

Four main roles of complement proteins are…

A
  • Opsonisation
  • Recruitment of phagocytes and inflammatory regulation (fragments)
  • Activation of B cells
  • Generation of MAC
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5
Q

The complement system may be intiated by three pathways…

A
  • Classical pathway (antibody binds to antigen on pathogen surface)
  • Lectin pathway (mannose-binding protein binds to pathogen surface)
  • Alternate pathway (spontraneous activation due to pathogen’s presence)
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6
Q

All 3 complement initiation pathways generate…

A

C3 convertase

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7
Q

C3 convertase leads to (3)…

A
  • Opsonisation
  • Inflammatory response
  • Production of MAC
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8
Q

Complement system nomenclature

Classical pathway proteins are designated by the letter __

Products of clevage reactions are denoted by the addition of a ________ _________

Alternate pathway compoenets are designated by other ________ __________

A

Complement system nomenclature

Classical pathway proteins are designated by the letter C

Products of clevage reactions are denoted by the addition of a lower case letter (e.g. a/b)

Alternate pathway compoenets are designated by other captial letters (e.g. B, D)

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9
Q

The addition of the a/b suffix to the protein name indicates small and large components respectively. The exception to this rule is in the case of…

A

C2, in which the ‘b’ component is infact larger

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10
Q

The classical pathway involves complement proteins…

A
  • C1q, C1r, C1s
  • C4
  • C2
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11
Q

The alternate pathway involves complement proteins…

A
  • Factor D
  • Factor B
  • Factor P (properdin)
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12
Q

Both classical and alternate pathways involve the complement protein…

A

C3

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13
Q

Terminal complement proteins…

A

C5, C6, C7, C8, C9 - which generate the MAC

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14
Q

Classical pathway

Step 1…

A
  • Antibodies bind to antigens on bacterial surface
  • C1q binds to IgM molecule OR to 2+ IgG molecules
  • C1q undergoes conformational change revealing C1r proteolytic site
  • C1r proteolytic site cleaves C1s from the complex

C1 complex -> C1s

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15
Q

Classical pathway

Step 2…

A
  • Active C1s cleaves C4 forming C4a and C4b
  • C4b binds covalently to pathogen surface
  • C4b is bound by C2
  • C1s cleaves the C2 resulting in C4b2a complex, aka C3 convertase
  • C3 convertase cleaves C3 forming C3a and C3b

C3a promotes inflammation

C3b may opsonise pathogen directly or join the C3 convertase complex

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16
Q

The main effect of the classical pathway is the accumulation of…

A

C3b on the pathogen surface (leading to phagocytosis by cells with complement receptors)

17
Q

Classical pathway

Step 3 (formation of MAC)…

A
  • C5 binds to C4b2a3b complex (generated by the addition of C3b to C3 convertase complex in the previous step) aka C5 convertase
  • C5 is cleaved to form C5a and C5b
  • C5b binds to pathogen surface
  • C6 binds to C5b forming C5bC6 complex
  • C5bC6 complex binds C7
  • Conformational change allows insertion of C7 into lipid bilayer of pathogen
  • C5bC6C7 binds C8
  • C5bC6C7C8 attracts C9, which forms pore in the pathogen membrane

C5bC6C7C8C9 is the complete membrane attack complex (MAC)

18
Q

How is C3 hydrolysed in the alternative pathway?

A

C3 hydrolysis is spontaneous (influenced by local environment)

19
Q

C3bBb is the C3 convertase found in which pathway?

A

Alternative

(Classical pathway C4b2a)

20
Q

In the alternative pathway C3 convertase (C3bBb) is stabilised by…

a) Factor B
b) Factor P
c) Factor F
d) Factor E

A

In the alternative pathway C3 convertase (C3bBb) is stabilised by…

a) Factor B

b) Factor P

c) Factor F
d) Factor E

21
Q

In the alternative pathway, factor B is cleaved by…

A

Factor D (forming C3bBb and Ba)

22
Q

What is the result of adding another C3b to the alternate C3 convertase (C3bBb)?

A

Formation of C3b2Bb (C5 convertase), which goes on to form the MAC

23
Q

The lectin pathway differs from the classical pathway in terms of the formation of which complex?

A

C4b2a (C3 convertase)

24
Q

Describe the formation of the C3 convertase in the lectin pathway

A
  • MASP-2 associated with MBL or ficolin cleaves C4
  • C4b binds to C2
  • MASP-2 cleaves C2
  • Result is C4bC2a complex (C3 convertase)
25
Q

Deficiencies in complement

Deficiency of C3 interferes with which 3 abilities and may lead to what?

A
  • Opsonisation
  • inflammation
  • cytolysis

May lead to life threatening bacterial infections

26
Q

Deficiencies in Complement

Deficiency in C6-9 impairs which process and leads to problems with which type of infection?

A

Cytolysis (formation of MAC), problems with neisseria infections

27
Q

Regulation of complement

Give examples of 3 regulatory proteins involved in the complement system…

A
  • C1 inhibitor (C1INH) - dismantles the C1 complex
  • Complement receptor 1 (CR1) - dismantles C3 convertase
  • Factor I - cleaves C3b or C4b