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Complement, infection, and autoimmunity

Conigliaro, Paolaa,*; Triggianese, Paolaa,*; Ballanti, Eleonoraa; Perricone, Carlob; Perricone, Robertoa; Chimenti, Maria Solea

doi: 10.1097/BOR.0000000000000633

Purpose of review Complement system dysfunction in terms of upregulation, downregulation, or dysregulation can create an imbalance of both host defense and inflammatory response leading to autoimmunity. In this review, we aimed at describing the role of complement system in host defense to inflection and in autoimmunity starting from the evidence from primary and secondary complement system deficiencies.

Recent findings Complement system has a determinant role in defense against infections: deficiencies of complement components are associated with increased susceptibility to infections. Primary complement system deficiencies are rare disorders that predispose to both infections and autoimmune diseases. Secondary complement system deficiencies are the result of the complement system activation with consumption. Complement system role in enhancing risk of infective diseases in secondary deficiencies has been demonstrated in patients affected by systemic autoimmune disorders, mainly systemic lupus erythematosus and vasculitis.

Summary The relationship between the complement system and autoimmunity appears paradoxical as both the deficiency and the activation contribute to inducing autoimmune diseases. In these conditions, the presence of complement deposition in affected tissues, decreased levels of complement proteins, and high levels of complement activation fragments in the blood and vessels have been documented.

aDepartment of Systems Medicine, Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata

bDipartimento Medicina Interna e Specialità Mediche, Lupus Clinic, Reumatologia, Sapienza Università di Roma, Rome, Italy

Correspondence to Roberto Perricone, Department of Systems Medicine, Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy. Tel: +39 06 20900587; e-mail:

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