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complement alternate pathway
Function:
- particularly important before the appearance of antibody in the response to infection
- does NOT use C1, C2 or C4
- activation begins with deposition of active C3, generating C3b
- depends upon the carbonyl group of the exposed thiolester of C3b to interact with an amide or hydroxyl group of a protein or a carbohydrate on the surface of the target
- initiation C3 convertase cleaves C3 to generate metastable C3b at a rate of 0.2-0.4% of plasma pool per hour
- C3b can bind covalently to an activator surface then bind properdin factor B
- properdin factor D cleaves factor B to generate the cell-bound C3 convertase C3bBb
- C3bBb decays rapidly, but is stabilized by binding of properdin increasing 1/2life from 1-18 minutes
- stabilized C3 convertase C3bBb cleaves more C3 to C3b that binds target
- amplification of C3b deposition on the activator surface leads to formation of the C5 convertase C3b2BbP that can trigger activation of the terminal components of complement C5-C9 resulting in formation of the membrane attack complex (MAC)
Pathology:
Defects in alternate pathway:
1) etiology
-> sickle cell disease
2) pathogens
a) Streptococcus pneumoniae
b) Salmonella species
Related
complement cascade
sickle cell (hemoglobin SS) disease
General
cascade
References
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 497
- Henry's Clinical Diagnosis & Management by Laboratory Methods,
21st edition, McPherson RA & Pincus MR (es), W.B. Saunders Co.,
Philadelphia, PA. 2007