Serum antibody response to the 70,000-molecular-weight neisserial common antigen in humans infected by Neisseria gonorrhoeae

Infectious diseases associated with complement deficiencies

The complement system consists of both plasma and membrane proteins. The former influence the inflammatory response, immune modulation, and host defense. The latter are complement receptors, which mediate the cellular effects of complement activation, and regulatory proteins, which protect host cells from complement-mediated injury. Complement activation occurs via either the classical or the alternative pathway, which converge at the level of C3 and share a sequence of terminal components. Four aspects of the complement cascade are critical to its function and regulation: (i) activation of the classical pathway, (ii) activation of the alternative pathway, (iii) C3 convertase formation and C3 deposition, and (iv) membrane attack complex assembly and insertion. In general, mechanisms evolved by pathogenic microbes to resist the effects of complement are targeted to these four steps. Because individual complement proteins subserve unique functional activities and are activated in a sequential manner, complement deficiency states are associated with predictable defects in complement-dependent functions. These deficiency states can be grouped by which of the above four mechanisms they disrupt. They are distinguished by unique epidemiologic, clinical, and microbiologic features and are most prevalent in patients with certain rheumatologic and infectious diseases. Ethnic background and the incidence of infection are important cofactors determining this prevalence. Although complement undoubtedly plays a role in host defense against many microbial pathogens, it appears most important in protection against encapsulated bacteria, especially Neisseria meningitidis but also Streptococcus pneumoniae, Haemophilus influenzae, and, to a lesser extent, Neisseria gonorrhoeae. The availability of effective polysaccharide vaccines and antibiotics provides an immunologic and chemotherapeutic rationale for preventing and treating infection in patients with these deficiencies.

Serum antibodies to cross-reactive Neisseria outer membrane antigens in healthy persons and patients with meningococcal disease

Outer membranes (OMs) were prepared from the Neisseria meningitidis (Nm) strain 44/76, N. gonorrhoeae (Ng) NRL 8658, and N. lactamica (N1) ATCC 23970. Paired serum samples from 16 patients with serogroup B Nm disease and single samples from 30 blood donors were tested for IgG antibody levels against the three OMs in indirect ELISA, before and after absorption of the sera with N1 OM. Immunoblot analysis was used to identify OM target antigens for cross-reacting and strain-specific antibodies. Most of the Nm- and NG-antibodies in sera from healthy adults were directed against OM antigens shared by the three Neisseria strains. Nm disease induced antibody formation against common Neisseria antigens, identified as the H.8 antigen and LPS determinants, against LPS determinants shared only by the Nm and Ng strains and against a variety of Nm-specific OM antigens. Very low levels of Nm-specific antibodies characterized the Nm patients in the acute phase. Also, the results indicate that the OM ELISA which has been used for the diagnosis of Nm disease, would be more useful if antibodies against common Neisseria antigens were removed from the sera before testing.