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Publication : Complement component 5 contributes to poor disease outcome in humans and mice with pneumococcal meningitis.

First Author  Woehrl B Year  2011
Journal  J Clin Invest Volume  121
Issue  10 Pages  3943-53
PubMed ID  21926466 Mgi Jnum  J:178491
Mgi Id  MGI:5298458 Doi  10.1172/JCI57522
Citation  Woehrl B, et al. (2011) Complement component 5 contributes to poor disease outcome in humans and mice with pneumococcal meningitis. J Clin Invest 121(10):3943-53
abstractText  Pneumococcal meningitis is the most common and severe form of bacterial meningitis. Fatality rates are substantial, and long-term sequelae develop in about half of survivors. Disease outcome has been related to the severity of the proinflammatory response in the subarachnoid space. The complement system, which mediates key inflammatory processes, has been implicated as a modulator of pneumococcal meningitis disease severity in animal studies. Additionally, SNPs in genes encoding complement pathway proteins have been linked to susceptibility to pneumococcal infection, although no associations with disease severity or outcome have been established. Here, we have performed a robust prospective nationwide genetic association study in patients with bacterial meningitis and found that a common nonsynonymous complement component 5 (C5) SNP (rs17611) is associated with unfavorable disease outcome. C5 fragment levels in cerebrospinal fluid (CSF) of patients with bacterial meningitis correlated with several clinical indicators of poor prognosis. Consistent with these human data, C5a receptor-deficient mice with pneumococcal meningitis had lower CSF wbc counts and decreased brain damage compared with WT mice. Adjuvant treatment with C5-specific monoclonal antibodies prevented death in all mice with pneumococcal meningitis. Thus, our results suggest C5-specific monoclonal antibodies could be a promising new antiinflammatory adjuvant therapy for pneumococcal meningitis.
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