The classical pathway

The classical complement pathway is activated most easily by IgM, and is also activated by IgG when IgG is fairly closely appositioned on the pathogen. IgM is a better complement activating Ig than IgG, because it has 5 Fc portions, but it has to be distorted on a cell surface to activate complement - it can't just be free floating.

The C1q molecule of the classical pathway is made of 6 rodlike structures, and at least two of them have to interact with the Fc portion of the Ig molecules, so it's more easy to activate it with IgM but IgG will work.

Acute phase proteins such as CRP C reactive protein and MBP mannose binding protein will also activate the classical complement pathway. MBP resembles C1q, and will bind mannose residues on bacterial surfaces, attracting Ig molecules, and triggering the pathway.

The classical pathway contains C1q, the associated r and s enzymatic proteins, C4, C4b, C2, and C4b2b aka C3/C5 convertase -- all of which are specific to the classical pathway. The rest of the pathway is shared by both the classical and alternative pathways.

The alternative pathway

The alternative pathway is activated by gram negative bacteria which contain lipopolysaccharide aka endotoxin on their surfaces, and also by yeast, rickettsia, venom, and viruses. This complement components exclusive to this pathway include factors B and D, C3bB, and C3bBb aka C3/C5 convertase, which is stabilized by properdin. This pathway depends on the presence in the serum of low amounts of C3b at all times. C3 is the most abundant plasma protein, and has a low spontaneous activation rate.

Complement inhibition

Normal cells inhibit this cascade as follows: C1 inhibitor breaks off r and s proteins. The absence of this inhibitor causes hereditary angioedema. DAF aka decay accelerating factor breaks down C4bC2b. C4Binding Protein prevents the formation of the C3 convertase of the classical pathway. Factor I inhibits the alternative pathway. LDLS and vitronectin prevent MAC formation.

Complement functions

Opsonization of bacteria, killing of organisms by lysis (MAC), chemotactic attraction of WBCs to inflammatory sites, removal of immune complexes, augmenting Ab response by localizing AGS to APCs and B cells. Some pathogens have evolved mechanisms to evade killing by complement (eg, bacterial capsules). Complement is involved in pathogenesis of some diseases, eg autoimmune dz, immune complex dz, et al.

MAC == C6789 -- puts a pore in pathogen membrane. Structurally homologous to perforins, made by 10-14 C9s polymerizing. NOTE: anaphylatoxins: C3a and C5a are anaphylatoxins. C5a is also a chemotactic agent.