Normo Hyper and Extreme Hypercomplementemia in
Human Chronic Periodontitis
Ibrahim M. S. Shnawa1, Baha H. H. Alamiedi2, Zainab M. H. Al Fatlawy3
1College of Biotechnology, University of Kasim , Kasim , Babylon / IRAQ
2Department of Basic Sciences, College of Dentistry, University of Babylon , Babylon / IRAQ
3Department of Oral Medicine, College of Dentistry, University of Babylon , Babylon / IRAQ
Email address:
ishnawa@yahoo.com (I. M. S. Shnawa)
To cite this article:
Ibrahim M. S. Shnawa, Baha H. H. Alamiedi, Zainab M. H. Al Fatlawy. Normo Hyper and Extreme Hypercomplementemia in Human
Chronic Periodontitis. American Journal of Biomedical and Life Sciences. Special Issue: Advances in Oral Immunity.
Vol. 3, No. 4-1, 2015
Abstract: Fourty-Nine chronic periodontitis patients were diagnosed by the dentist of the team. Of which 27 were
generalized chronic and the other 22 were localized chronic periodontitis. Ten subjects with normal mouth hygienewere
considered as controls. Blood,and saliva samples were collected from both of the test patients and controls. Sera, saliva and
salivary proteins were subjected to C3 and C4 determinations using ready made plates ofradial immunodiffusion in gel
containing anti-C3 and anti-C4 antibodies. Generalized chronic periodontitis patients were showing higher C3 levels than
localized chronic periodontitis patients. Both of thedisease forms were of higher C3 and C4 levels than controls. Females have
lower C3 levels than male chronic periodontitis patients. C4 levels were slightly increased than normal control levels. Male C4
levels approximate female levels. Four cases ofC3 and C4 hypercomplementemia in each of the disease forms.One
extremecombinedC3 and C4 hypercomplementemia in the generalized form and one extreme C4 hypercomplementemiawas
noted in the localized form. Thus, normo, hyper and extreme hypercomplementemia C3 and C4 were noted among chronic
periodontitis patients. These hypercomplementemia cases are secondary non-genetic, infection and /or inflammation induced.
Keywords: Chronic, Complement C3 and C4, Localized


1. Introduction
Today, insight to the immune system is functional in its
attitude. In thjis attitude, immune system may be expressed
as triportate system having; Natural (Innate), cross-road and
adaptivefunctions [1, 2]. Structurally speaking, however, it
consist of ;Lymphoid component, Haemopoietic component,
mononuclear phagocyte component, Complement component
and genetic component [3]. Among which, complement
system [1] in its functional sense occupy an immune crossroad
function [4]. Since it takes partboth in natural and
adaptive immunity [4].Complement system has three
activation pathways, namely, the classical, the properidin and
the lectin pathways. The classical pathway,almost operates in
adaptive immunity [3, 4]. During adaptive responses there is
continual activation for the classical pathway mediated by
eitherand/ or inflammation. Such activation may lead to
either excessive activation outcomes or to downregulation
that might causing pathologic conditions [5]. In chronic
infection state like periodontitis, in which the infectious
agent and its own specific antibodies forms complexes
deposited inthe gum, periodontal tissues as well as the
stomium melliue in general. The C3 and C4 levels in the gum
and periodontal tissue approximate 1/25 or 1/3 that of
circulating levels, besides the difficulty in their detection due
to either rapid degradation or immune complexdeposition [6,
7]. The aim of the present work was to report on hyper and
extreme hypercomplementemia in chronic periodontitis
patients.
2. Main Body
Fourty-Nine chronic periodontitis patients were diagnosed
by the dentist in the team. Of which 27 were generalized
form and 27 were localized form. Ten normal mouth hygiene
subjects were elected for the study ascontrols [8, 9].
American Journal of Biomedical and Life Sciences2015; 3(4-1): 4-6 5
Blood(without anticoagulant) and saliva samples were
collected as in [10]. Salivary proteins were separated as in
[10, 11]. Sera, saliva and salivary proteins were subjected to
C3 and C4 determinations using ready made plates of radial
immunodiffusion in gel containing anti-C3 and C4 antibodies
[12]. Biometery was performed as in [13].
3. Results and Discussion
There were elevations of the serum C3 concentration mean
values that ranged from 1. 5 to 2 folds than that of controls.
Males have higher mean values than females Table 2. There
was an age group-wise variations in C3 concentration
meansTable 3. The C3 herd plotwasof normal distribution
curve, patients were showing; low moderate and high C3
responders Figure 1. The overallC4 concentration means
were presented in Table 3. Males approximate or slightly
higher than female periodontitis patients.Combined C3 and
C4 hypercomplementemia were found as three cases among
the generalizedform of the diseaseand asfour cases among the
localized form of the disease. One case of extreme hyper
complementemia in each of the disease forms Table 4. Whole
saliva preparations and salivary protein preparations were
found tobe C3 and C4 negativein the test patients and
controls.
The C3 herd plot as well as the complement response
patterns as low, moderate and high among periodontitis
patients can act as a probe of herd immunity among
periodontitispatients in this area Figure 1. [14]. The absence of
C3 and C4 complement components can either due to rapid
degradation of complement by gum tissue micro -
environmental enzyme activities. Or due to immune complex
deposition in the periodontal tissues [15, 16, 17, 18, 19]
Single C3, C4 and combined C3-C4 hypercomplementemias
can be attributed to the continual exposure to the periodontal
bacterial pathogens or to their antigens alone or together with
epitope-paratope-complement complexes. Another, possibility
of physiological nature that might be the cause, which is the
replenishing responses toan in situerapid complement
catabolism [4, 20, 21]
Blood(without anticoagulant) and saliva samples were
collected as in [10]. Salivary proteins were separated as in
[10, 11]. Sera, saliva and salivary proteins were subjected to
C3 and C4 determinations using ready made plates of radial
immunodiffusion in gel containing anti-C3 and C4 antibodies
[12]. Biometery was performed as in [13].
3. Results and Discussion
There were elevations of the serum C3 concentration mean
values that ranged from 1. 5 to 2 folds than that of controls.
Males have higher mean values than females Table 2. There
was an age group-wise variations in C3 concentration
meansTable 3. The C3 herd plotwasof normal distribution
curve, patients were showing; low moderate and high C3
responders Figure 1. The overallC4 concentration means
were presented in Table 3. Males approximate or slightly
higher than female periodontitis patients.Combined C3 and
C4 hypercomplementemia were found as three cases among
the generalizedform of the diseaseand asfour cases among the
localized form of the disease. One case of extreme hyper
complementemia in each of the disease forms Table 4. Whole
saliva preparations and salivary protein preparations were
found tobe C3 and C4 negativein the test patients and
controls.
The C3 herd plot as well as the complement response
patterns as low, moderate and high among periodontitis
patients can act as a probe of herd immunity among
periodontitispatients in this area Figure 1. [14]. The absence of
C3 and C4 complement components can either due to rapid
degradation of complement by gum tissue micro -
environmental enzyme activities. Or due to immune complex
deposition in the periodontal tissues [15, 16, 17, 18, 19]
Single C3, C4 and combined C3-C4 hypercomplementemias
can be attributed to the continual exposure to the periodontal
bacterial pathogens or to their antigens alone or together with
epitope-paratope-complement complexes. Another, possibility
of physiological nature that might be the cause, which is the
replenishing responses toan in situerapid complement
catabolism [4, 20, 21]
Figure 1. Serum C3 herd plot of chronic periodontitis patients
Table 1. The study patients
Number of patients
Entity
Male Female Total
-Generalized chronic periodontitis 17 10 27
-Localized chronic periodontitis 15 7 22
Total 32 27 49
Table 2. C3 concentrations mean in the seraofperiodontitis patients
Mean C3 concentrations (mg/dl)
Entity
Male Female Total
Generalized chronic 175. 57 171. 22 173. 34
Localized chronic 180. 19 134. 44 157. 67
Control 106. 6 90. 95 98. 5
Total 178. 19 152. 3 165. 51
Table 3. C4 concentrations means in sera of periodontitis patients
C4 concentrations (mg/dl)
Entity
Male Female Total
Generalized chronic 51. 4 47. 51 49. 31
Localized chronic 49. 2 47. 41 48. 8
Control 31. 08 33. 3 32. 19
Total 50. 15 47. 46 48. 8
Table 4. Hypercomplementemia inperiodontitis patients sera
Concentration in
mg/dl Hypercomplementemia
Type
Chronicperiodontitis
type
C3 C4
197. 4 50. 3
Generalized Combined
192. 4 50. 8
Extreme combined 203. 2 61. 4
- 50. 5
Single
197. 4 -
197. 4 50. 3
Combined
Localized
197. 4 51. 4
197. 4 57. 4
Extreme combined 198 61. 8
4. Conclusions
1-Chronic periodontitis is associated with rise in C3 and
C4 levels.
2-Normo, hyper and extreme hypercomplementemia were
noted among periodontitis patients
3-C3 levels may be of use as a probe for herd immunity
among periodontitis patients.
Acknowledgments
The authors wish to thank, department of biology, college
of science, department basic science, department of oral
medicine college of dentistry, Babylon University for help
extended by them during the conduction of this work.
6 Ibrahim