ABSTRACT
In addition to summarizing and updating the information on CARPA, namely its symptoms, prevalence, unique features and mechanism, a main goal of this chapter is to highlight the “vigilance” of the C system to recognize and attack nanomedicines because they resemble viruses and other pathogenic nano-organisms. Another goal is to review how foreign and host cells, bacteria, and viruses defend themselves against C attack, which provides hints on how to protect drug candidates against CARPA. The chapter also acquaints the reader with a novel approach to preventing liposome-induced CARPA by way of desensitization with drug-free (placebo) vesicles. Finally, a new concept is described, proposing CARPA to represent a stress reaction in blood. 35.2 Complement Surveillance with Multivision
Camera and Machine GunThe complement (C) system is an evolutionarily ancient homeostatic protein network in the body that consists of some 36 glycoproteins in blood and on cell surfaces. Accordingly, C proteins are either soluble or membrane-bound. In both fractions, some of the proteins take part in the activation chain, either as cascade or as receptor proteins, while others play inhibitory or controlling roles (Table 35.1).The soluble fraction represents ~5% of serum globulin. The C system is best known as a part of the immune system; namely, it represents the humoral arm of nonspecific, innate immunity. Although C was discovered approximately 120 years ago (in 1895 by Jules Bordet), even today scientists find startling new physiological roles for the system, most recently in conception, tissue repair, and growth [1]. Pathologic alterations of the system have been associated with a long list of illnesses [1, 2].
