Complement assays

The function of the complement system is to eradicate pathogens and dispose of dead and dying cells. Deficiencies in complement proteins or in complement regulators, either primary or secondary, may lead to increased susceptibility to infections, autoimmune diseases and certain kidney diseases.

At Sanquin not only quantitative tests are performed, we also perform functional tests. Complement function and/or complement protein concentrations may be monitored in the context of response to therapy or to follow disease progression.

The complement tests that we offer in this context and the field of application are mentioned in the table below:

Functional tests Context Antigen conc. tests Context
C1-INH act Angiooedema C1q Angiooedema, autoimmunity
C3NeF MPGN type II / Dense Deposit Disease C3 Autoimmunity, Kidney problems (aHUS, MPGN type II), comsumption
C4-dep MBL deficiency C4 Angiooedema, autoimmunity
CH50 Complement consumption, dosing Biologicals, Eculizumab treatment C1-INH conc Angiooedema
AP50 Eculizumab treatment, Complement consumption C2 Complement consumption classical pathway
fH activity aHUS C5 Complement consumption/deficiency
Consumption context fB Complement consumption alternative pathway
C3d Complement consumption, dosing Biologicals fH aHUS
C5b-9 Eculizumab treatment Anti- C1-INH Acquired angioedema


Cazander G, Schreurs MW, Renwarin L, Dorresteijn C, Hamann D, Jukema GN. Maggot excretions affect the human complement system. Wound Repair Regen 2012; 20(6):879-86.

Wagenaar-Bos IG, Drouet C, Aygören-Pursun E, Bork K, Bucher C, Bygum A, Farkas H, Fust G, Gregorek H, Hack CE, Hickey A, Joller-Jemelka HI, Kapusta M, Kreuz W, Longhurst H, Lopez-Trascasa M, Madalinski K, Naskalski J, Nieuwenhuys E, Ponard D, Truedsson L, Varga L, Nielsen EW, Wagner E, Zingale L, Cicardi M, van Ham SM. Functional C1-inhibitor diagnostics in hereditary angioedema: assay evaluation and recommendations. J Immunol Methods 2008; 338(1-2):14-20.

Bultink IE, Hamann D, Seelen MA, Hart MH, Dijkmans BA, Daha MR, Voskuyl AE. Deficiency of functional mannose-binding lectin is not associated with infections in patients with systemic lupus erythematosus. Arthritis Res Ther 2006; 8(6):R183.

Familian A, Voskuyl AE, van Mierlo GJ, Heijst HA, Twisk JW, Dijkmans BA, Hack CE. Infliximab treatment reduces complement activation in patients with rheumatoid arthritis. Ann Rheum Dis 2005; 64(7):1003-8.

Wolbink GJ, Bollen J, Baars JW, ten Berge RJ, Swaak AJ, Paardekooper J, Hack CE. Application of a monoclonal antibody against a neoepitope on activated C4 in an ELISA for the quantification of complement activation via the classical pathway. J Immunol Methods 1993; 163(1):67-76.

Last edited on: 3 November 2015