Why are complement activity biomarkers valuable?

During the last decade, the importance of the complement system has become evident in both clinical medicine and complement therapeutics. This increased interest means a more prominent need for assays to evaluate complement activity. 

Activity biomarkers are used to determine whether deficiencies, overactivation or dysregulation in the complement system are causing, or contributing to, a person's disease or condition.

In order to exactly measure such activation, assays for quantification of products formed during activation are required.

 

Svar Complement Activity Biomarkers

Excellent biomarkers for complement activity 

The Svar Complement activity biomarkers give valuable intelligence in several situations where one might suspect that complement activation plays a role in the disorder. The Svar assays for complement activity biomarkers are developed to target the unique neoepitopes only presented at the complement component or complex when activated.

Reduced hands-on-time

The Svar Complement C4d, launched in 2018, and the Complement TCC are flexible and easy to use enzyme immunoassays with ready to use reagents and short incubation times leading to reduced hands-on-time for the user.

Suitable for safety testing

The Svar complement activity biomarkers are well suited for studies of complement activation in drug development and medical devices, i.e. biological safety testing and as part of the recommended tests for assessing complement activation according to ISO standard 10993-4 for hemocompatibility testing.

HEMOCOMPATIBILITY

Providing safer treatment

Complement activity biomarkers are recommended to predict possible adverse reactions from medical devices such as grafts, stents, hemodialysis and cardiopulmonary bypass but also to biological drugs and nanomedicines.


Complement TCC is part of the recommended tests for assessing complement activation according to ISO standard 10993-4.

DRUG SAFETY

Preventing adverse reactions

Patients are each year are affected by adverse reactions that might be complement activated. These reactions are critical and can lead to death.

Complement activity biomarkers can be used successfully for investigation to rule out if a drug is toxic or if a reaction is due to other related issues such as “infusion reactions” and  more specifically complement activation-related pseudoallergy (CARPA). Infusion reactions has been reported to several pharmaceuticals such as biologicals and nanomedicines.

Complement C4d

Plays a prominent role in transplantation and autoimmunity

C4d has the potential to detect patients at risk for the consequences of antibody-mediated disease and the development of new therapeutics that block complement activation makes C4d a biomarker with potential to identify and monitor patients who may possibly benefit from these drugs.

Stable marker associated with transplant rejection

C4d has been used for a long time as a histological biomarker for complement activity and is recognized for its stability and strong association with antibody mediated rejcetion (AMR) of grafts. C4d in plasma is now increasingly identified as a biomarker for complement activation and as a tool to predict and monitoring flares in for example SLE, Systemic sclerosis and ANCA–associated vasculitis. Several studies are ongoing to evaluate and study plasma C4d as biomarker in a wide area of clinical situations.

Useful biomarker within the cancer area 

C4d has also been evaluated as a useful biomarker within the cancer area. Studies indicate that C4d may be of both diagnostic and prognostic value in different types of lung cancer. C4d adds diagnostic value to the evaluation of indeterminate lung nodules allowing patient stratification. In malignant pleural mesothelioma, C4d levels have been shown to correlate with tumor load and chemotherapeutic response.

Complement TCC

Universal activity biomarker independent of activation pathway

Measuring TCC levels can be very informative as a supplement to functional assessment of the three complement pathways. As a product of the terminal pathway, TCC can be a result from all three complement activation pathways,  and reflects the total in vivo activity of complement.

Enabling effective treatment

Increased levels of TCC can be  detected in both acute injury and inflammation like trauma and sepsis and in chronic inflammation and diseases like atypical hemolytic uremic syndrome (aHUS), Systemic lupus erythematosus (SLE), ANCA associated vasculitis and rheumatoid arthritis (RA). 

Preventing adverse reactions 

The complement system can also be activated by artificial surfaces, for example during hemodialysis or cardiopulmonary bypass, resulting in increased levels of TCC. TCC is therefore well suited for studies of complement activation by biomaterials in medical devices and part of the recommended tests for assessing complement activation according to ISO standard 10993-4 for hemocompatibility testing. 

"Pathologically increased complement activation can indirectly be evaluated by quantification of complement components, but in order to exactly measure such activation, assays for quantification of products formed during activation are required."

(Bergseth G et al, 2013)