Abstract
To determine whether serum immure complex formation occurs following intratracheal instillation of exogenous human surfactant in infants with severe RDS, an ELISA assay for surfactant-anti-surfactant immune complexes was developed using rabbit anti-human surfactant antibodies followed by horseradish-peroxidase antihuman Ig. Anti-surfactant antibody formation during the first 3 months following surfactant instillation was measured & C50 & C3 levels & urinalysis were performed to determine whether the classical pathway was activated. Seven infants receiving exogenous human surfactant & 11 infants with severe RDS receiving only intermittent mandatory ventilation (IMV) were compared. Serum surfactant-anti-surfactant immune complex formation was detected shortly after surfactant instillation & peaked in concentration (O.D.490) 7 days after treatment versus a peak in surfactant-anti-surfactant immune complex formation 12 days after birth in infants with severe RDS receiving only IMV. Complexes could be detected for 2 months following surfactant administration & for 25 days in IMV treated infants. C50 levels in surfactant treated infants was 90 ± 15 vs. 105 ± 22 U/ml & C3 levels were similar in both groups & urinalysis did not reveal proteinuria. Although some variation in time course & peaks was observed, a consistent pattern of surfactant-anti-surfactant complexes was found in infants with RDS. These findings underscore the need for caution in administration of xenogenic biologically active substances to human infants.
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Strayer, D., Merritt, T. & Hallman, M. IMMUNE COMPLEX FORMATION IN RESPIRATORY DISTRESS SYNDROME (RDS). Pediatr Res 18 (Suppl 4), 398 (1984). https://doi.org/10.1203/00006450-198404001-01830
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DOI: https://doi.org/10.1203/00006450-198404001-01830