Page 2The complement pathway. Complement can be activated through three pathways: classical, lectin, and alternative. The classical pathway is activated when C1q binds to antibody attached to antigen, activating C1r and C1s, which cleave C4 and C2. The lectin pathway is activated when mannose-binding lectin (MBL) encounters conserved pathogenic carbohydrate motifs, activating the MBL-associated serine proteases (MASPs) and again cleaving C4 and C2. C4 and C2 cleavage products form the classical and lectin pathway C3 convertase, C4bC2a, which cleaves C3 into C3b and C3a. A second molecule of C3b can associate with C4bC2a to form the C5 convertase of the classical and lectin pathways, C4bC2aC3b. The alternative pathway (AP) is activated when C3 undergoes spontaneous hydrolysis and forms the initial AP C3 convertase, C3(H2O)Bb, in the presence of Factors B and D, leading to additional C3 cleavage and eventual formation of the AP C3 convertase (C3bBb) and AP C5 convertase (C3bBbC3b). Properdin facilitates AP activation by stabilizing AP convertases. All three pathways culminate in the formation of the convertases, which in turn generate the major effectors of the complement system: anaphylatoxins (C4a/C3a/C5a), the membrane attack complex (MAC), and opsonins (e.g., C3b). Anaphylatoxins are potent proinflammatory molecules derived from the cleavage of C4, C3, and C5. The MAC is a terminal assembly of complement components C5b through C9, which can directly lyse targeted surfaces. C3b induces phagocytosis of opsonized targets and also serves to amplify complement activation through the AP. |