Complement activation, as shown by increased amounts of complexes composed of Clr-Cls-Cl IA, and abnormal complexes of Clr-Cls were demonstrated in serum from patients with acute pneumococcal and chronic otitis media, serous or mucoid respectively. C1q binding substances were shown in middle ear effusions and in sera from patients with chronic serous otitis media. Presence of immune complexes and/or bacterial products capable of binding Clq results in formation of Clr-Cls-C1 IA complexes and may also cause the generation of Clr-Cls complexes. Such a dissociation of the C1 component will compromise the important opsonic function of the classical pathway.
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