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Off to a slow start: under-development of the complement system in term newborns is more substantial following premature birth

McGreal, Eamon Patrick, Hearne, Keziah and Spiller, Owen Bradley 2012. Off to a slow start: under-development of the complement system in term newborns is more substantial following premature birth. Immunobiology 217 (2) , pp. 176-186. 10.1016/j.imbio.2011.07.027

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Abstract

Complement represents a keystone to the innate immune system, with three activation pathways that utilise foreign microbial pattern recognition as well as activation by the host's specific antibodies. However, innate immunity is not synonymous with neonatal immunity. The complement system in healthy term (38–42 weeks gestation) newborns is under-developed and, with only a few exceptions (e.g. C7 and factor D), the circulating complement component concentrations are between 10 and 80% of adult levels. Complement activation is tightly regulated and the circulating regulator levels are also low relative to adults, sometimes at almost undetectable levels (e.g. C4b-binding protein). For premature newborns, these relative deficiencies are even more marked. Newborns are known to be more susceptible to infection, and the importance of complement, not only through its decreased ability to directly lyse bacteria with the common terminal pathway, but also its reduced ability to recruit (chemotaxis) innate and adaptive leukocytes to sites of microbial invasion and reduced ability to enhance phagocytosis (opsonisation) will be discussed. Complement also holds a key role in enhancing and directing refinement of the specific antibody response to pathogens (as an adjuvant) that likely plays a role in the well-known under-performance of the humoral immune response in newborns.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Uncontrolled Keywords: complement, neonates, innate immune system, premature neonates
Publisher: Elsevier
ISSN: 0171-2985
Last Modified: 07 Jul 2020 13:36
URI: http://orca.cf.ac.uk/id/eprint/25541

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