Send to

Choose Destination
Sci Rep. 2017 Feb 14;7:42532. doi: 10.1038/srep42532.

The alternative complement pathway is dysregulated in patients with chronic heart failure.

Shahini N1,2,3,4, Michelsen AE1,2, Nilsson PH4,5,6, Ekholt K4, Gullestad L3,7, Broch K7, Dahl CP1,7, Aukrust P1,4,8, Ueland T1,3,4, Mollnes TE4,5,9,10, Yndestad A1,2,3,4, Louwe MC1,2,3,4.

Author information

Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Center for Heart Failure Research, University of Oslo, Oslo, Norway.
K.G. Jebsen Inflammation Research Centre, University of Oslo, Oslo, Norway.
Department of Immunology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Linnaeus Centre for Biomaterials Chemistry, Linnaeus University, Kalmar, Sweden.
Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Research Laboratory, Nordland Hospital, Bodø, and K.G. Jebsen TREC, University of Tromsø, Tromsø, Norway.
Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway.


The complement system, an important arm of the innate immune system, is activated in heart failure (HF). We hypothesized that HF patients are characterized by an imbalance of alternative amplification loop components; including properdin and complement factor D and the alternative pathway inhibitor factor H. These components and the activation product, terminal complement complex (TCC), were measured in plasma from 188 HF patients and 67 age- and sex- matched healthy controls by enzyme immunoassay. Our main findings were: (i) Compared to controls, patients with HF had significantly increased levels of factor D and TCC, and decreased levels of properdin, particularly patients with advanced clinical disorder (i.e., NYHA functional class IV), (ii) Levels of factor D and properdin in HF patients were correlated with measures of systemic inflammation (i.e., C-reactive protein), neurohormonal deterioration (i.e., Nt-proBNP), cardiac function, and deteriorated diastolic function, (iii) Low levels of factor H and properdin were associated with adverse outcome in univariate analysis and for factor H, this was also seen in an adjusted model. Our results indicate that dysregulation of circulating components of the alternative pathway explain the increased degree of complement activation and is related to disease severity in HF patients.

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Nature Publishing Group Icon for PubMed Central Icon for Norwegian BIBSYS system
Loading ...
Support Center