Preferential Activation and Depletion of the Alternative Complement Pathway by Burn Injury

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Abstract
Complement levels of 8 adult burn patients (256-90% body surface area) were studied upon admission to a burn unit and sequentially for 1 wk. Mean classical pathway titers (CH50) were 49% below the normal mean, while hemolytic C4 titers were reduced by 53% and C3 by 43%. The alternative pathway titer was reduced by > 90%, suggesting preferential depletion of this pathway. This depletion was associated with sepsis, pneumonia, and shock lung. Alternative pathway deficiency was still present 1 wk post-burn and may contribute to the susceptibility of burn patients to bacterial sepsis.