Anaphylatoxin generation in multisystem organ failure.

Complement components were studied in 44 patients with extensive injuries or infections. The concentrations of anaphylatoxins (C4a, C3a, and C5a) and other complement components (C1INH, C4, C3, and C5) were determined in plasma using radioimmunoassay and rocket immunoelectrophoresis techniques. The results were correlated with the development of multisystem organ failure (MSOF). In particular, plasma concentrations of C3a and C4a were found elevated in trauma patients. These elevated anaphylatoxin levels were correlated with severity of the injury. As reported in other types of patients, the apparent C5a plasma levels were not elevated. Therapy reduced the plasma levels of C3a with great predictability. It appears that plasma C3a and C4a levels may relate not only to severity of the injury but may signal onset of secondary events such as bacteremia. Consequently, longitudinal monitoring of anaphylatoxin levels may prove helpful in diagnosing the status of trauma patients.