A Newly Described Control Mechanism of Complement Activation in Patients with Mixed Cryoglobulinemia (Cryoglobulins and Complement)

Levels in serum of components of complement were studied in a group of 10 patients with mixed cryoglobulinemia. The profiles found in most patients showed decreased levels of the early complement components C1, C4, and C2, with normal levels of C3. Experiments performed to define the mechanism(s) responsible for this unusual complement profile showed that activation of the early complement components in serum was due to the activation of the classical pathway by mixed cryoglobulins. They also showed that the characteristic lack of effect on C3 was due to the action of a previously unrecognized regulatory mechanism upon C3 convertase of the classical pathway mediated by 2 normal serum proteins, namely, the C4 binding protein (C4-bp) and the C3b inactivator (C3bINA).