or (formerly) alexin(e)
a system of proteins and cell receptors, found in the plasma of vertebrates, that participates in immune defence against infection by microorganisms; the activation products of complement components cause lysis of antigenic cells, attract phagocytic cells to the site of activation, and assist the uptake and destruction of antigenic cells by phagocytes. Complement is also involved in immunological tissue injury. The plasma components comprise a recognition unit, three alternative pathways for activation of C3 (the classical pathway uses C2 and C4), and a terminal pathway that ends in the formation of the membrane attack complex (C356789). Synthesis occurs mainly in hepatocytes and that of several components is regulated by interleukins 1 and 6, tumour necrosis factor, γ interferon, and endotoxic polysaccharide. The plasma components amount to about 2000 mg L
−1 (C1 ≈250, C3 ≈1200, C4 ≈400 mg L
−1). The components of complement, mostly β- or γ-globulins, are generally designated by the symbol C and an identifying suffixed numeral. There are three alternative pathways for activation of complement, and these probably work together. The classical pathway is followed below. The alternative pathway uses properdin and factors B and D to activate C3 and C5. The lectin pathway utilizes mannose-binding protein and its associated serine protease (
MASP), and activates C3 as in the classical pathway but without a requirement for C1.
C1
is a Ca
2+-dependent complex of C1q, C1r, and C1s in the molar ratio of 1:2:2. C1q has a 'bunch-of-tulips' structure that consists of six collagen-like triple helices each ending in a globular C-terminal domain, which binds the Fc region of immune complexes. Each triple helix consists of homologous A, B, and C chains, which are encoded on neighbouring genes, and contain a collagen-like domain over ≈80% of their length, while the rest contributes to the C-terminal globular head. C1r and C1s are highly homologous serine protease zymogens (83 kDa per subunit). Two subunits of each bind C1q in a calcium-dependent but noncovalent manner. Binding of ligand to C1q causes a conformational change in, and autocatalytic activation of, C1r (EC 3.4.21.41), which then cleaves and activates C1s. The natural substrates for C1s are C2 and C4. Deficiency of A, B, or C chains of C1q results in the clinical phenotype of lupus erythematosus. Deficiency of C1r or C1s also leads to this phenotype or to glomerulonephritis.
C2
is a single-chain polypeptide (102 kDa) that is highly homologous with factor B. C1s releases a small peptide (S2b) and (active) C2a. C2a and C4b form a bimolecular enzyme called
C3 convertase, a serine proteinase (EC 3.1.21.43). Deficiency of C2 results in rheumatic disorders and pyogenic infections.
C3
is a glycoprotein (185 kDa) that consists of an α chain linked by a disulfide bond to a β chain, both being derived from the same precursor, which is homologous with C4 and C5. The α chain contains an intrachain thiol ester that is important for the function of C3. C3 convertase (i.e. C4b2a) cleaves a small peptide, which is the N-terminal region of the α chain, to expose the thiol ester. C3a is an anaphylatoxin. The rest of the molecule (C3b) binds covalently (through the thiol ester) to cell surfaces or the immune complex, and in complex with C3 convertase forms C4b2a3b, which is called
C5 convertase. Deficiency of C3 leads to rheumatic disorders and pyogenic infections.
C4
is a glycoprotein (200 kDa) that consists of disulfide bond-linked α, β, and γ chains, all derived from the same precursor, which is homologous to those of C3 and C5. The α chain contains an intrachain thiol ester, which is important for the function of C4. C1s releases C4a, the N-terminal portion of the α chain, and exposes the thiol ester. This binds covalently to cell surfaces or to immune complexes. The rest of the molecule is C4b, which with C2a forms C4b2a, or C3 convertase. In combination with C3b, C3 convertase forms C4b2a3b, which is C5 convertase. Deficiency of C4 leads to a lupus e rythematosus phenotype. The human form is polymorphic, the allotype being C4a. C4a alleles carry blood group Rogers and C4b alleles carry Chido. Total deficiency of C4a6 allotype is associated with hemolytic disease.
C5
is a glycoprotein (190 kDa) that consists of an α chain linked by a disulfide bond to a β chain, both derived from a precursor homologous to those of C3 and C4. C5 convertase (i.e. C4b2a3b) releases a small anaphylatoxic and leukocyte-attractant peptide (C5a), which is the N-terminal region of the α chain. Activation of C5 initiates the spontaneous assembly of the late complement components, C5 — C9, into the membrane attack complex (see
MAC (def. 1)). C5b recruits a molecule of each of C6, C7, and C8, which insert their hydrophobic regions into the target cell membrane. Deficiency of C5 leads to meningococcal infection.
C6, C7, C8, and C9,
together with C5b, constitute the membrane attack complex; all are structurally related and similar to
perforin. C6 is a single-chain polypeptide (128 kDa) that interacts with C5b, C7, and C8. C7 is a single-chain polypeptide that interacts with C5b, C6, and C8. C8 is a heterotrimer comprising: α, β, and γ subunits. An α chain is linked by a disulfide bond to a γ chain, and a β chain then links to these two chains. C8 interacts with C5b, C6, and C7, the complex inserting into the target cell membrane. C9 is a single-chain polypeptide (70 kDa). From 1 to 18 molecules of C9 are recruited by the C5b678 complex to form a tubular transmembrane channel that disturbs the target cell membrane and increases its permeability. It is cleaved by thrombin to form C9a and C9b. Deficiency of C6, C7, C8, or C9 is associated with meningococcal infection.
Factor B
, a zymogen of
Mr 100 000, is activated by factor D, which selectively cleaves an Arg-∣-Lys bond when factor B is complexed with C3b to form factor Bb. Following cleavage the C3b-Bb complex acts as
alternative-complement-pathway C3/C5 convertase (EC 3.4.21.47), which can convert C3 to C3a and C3b by cleaving an Arg-∣-Ser bond, and C5 to C5a and C5b by cleavage of an Arg-∣-Xaa bond.
Factor D̄
is a serine proteinase (EC 3.4.21.46) of
Mr 24 000; its concentration in human plasma is approximately 1.5 mg L
−1.
Factor H
is a cofactor for
factor I (EC 3.4.21.45), a serine proteinase that cleaves the α chains of C4b and C3b in the presence of the cofactors for C4-binding.
Properdin
, a glycoprotein of
Mr 220 000, is composed of four, probably identical, noncovalently linked polypeptide chains. Two alternative reaction cascades for the activation of complement exist. In the so-called
classical pathway, activation (which requires both Ca
2+ and Mg
2+) is initiated by the binding of the C1q moiety of C1 to the C
H2 regions of antibody molecules in antibody-antigen aggregates or in antibody bound to cells, thus causing C1 to be converted to a proteinase, C1̄. C1̄ activates C4 and C2 leading to the formation of
C3 convertase, a complex proteinase, C42̅, consisting of the activated components C4̄ and C2̄. C42̅ splits C3 to the chemotactic and anaphylatoxic fragment C3a and the fragment C3̄, C3b, which associates with C42̅ to give a

complex,
C5 convertase. The latter is a complex proteinase that in turn splits C5 to C5̄ and the chemotactic and anaphylatoxic fragment C5a. In the so-called
alternative pathway, activation (which requires Mg
2+ but not Ca
2+) is initiated by polysaccharides such as those present on bacterial and yeast cell walls. The proteinase D̄ is analogous to C1̄ but is normally present in serum, where it causes a continuous slow activation, which is greatly enhanced when polysaccharides are present. D̄ acts on B and C3̄ to produce C3B̅, an alternative C3 convertase. C3B̅, which is stabilized by properdin, acts on C3 to produce (C3̄)
nB̄, an alternative C5 convertase. In both pathways, C5̄ production is the last proteolytic step, and there follows a spontaneous association of C5̄ with C6, C7, C8, and C9 to form a lytic complex,

. See also
lysine(arginine) carboxypeptidase.