Reviewer's report 
 Complement Activation Capacity in Plasma before and during High-dose Prednisolone Title: 
Treatment and Tapering in Exacerbations of Crohn's Disease and Ulcerative Colitis 
 2  10 April 2005 Version: Date: 
 Ole Haagen H Nielsen Reviewer: 
Reviewer's report: 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached)General This is an interesting study focusing on the complement activation capacity 
among IBD patients evaluated in plasma samples with relation to glucocorticoid treatment. It is 
revealed that complement activation capacity is upregulated in Crohn’s disease. 
Major comments: 
The complement system is often overlooked in relation to the inflammatory response seen in 
ulcerative colitis and Crohn’s disease. However, some relatively few researchers have focused deeply on this topic among others: Jens Elmgreen who defended a doctoral thesis around 15 years 
ago (not mentioned in references). 
For the general reader the authors should consider to add a little more information (some few more 
sentences in introduction) regarding the difference between the classical and alternative 
complement activation cascades. The aim should also be strengthened: why it is of interest to 
analyse an association between complement activation capacity and treatment? As a result the 
conclusion of the present paper is rather vague (e.g. “further studies are needed” and “to clarify the 
roles”). 
Which impact do the authors believe the information retrieved from the present experimental study might reach in the future clinical situation? 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the 
author can be trusted to correct)Minor comments: 1. Some logical steps are missing in the Background. As an example: Further insight into the 
complement system continues to emerge, e.g. that MBL. More focus should be attended to MBL (but 
also C4b/iC4b) than just the above mentioned sentence, as MBL seems to be rather central for the 
present paper. 2. Was any differences observed in those 10 patients still on glucocorticoid as compared to those tapered out after 12 weeks? 
3. I believe the ethical standards are in accordance with the declaration of Helsinki V. 
4. The association between the obtained results and NF-&#954;B (last sentence of Discussion section) is speculative. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
Ole Haagen Nielsen 
Associate professor, chief physician, MD, DMSc 
dept. of Gastroenterology C112 
Herlev Hospital University of Copenhagen 
Herlev Ringvej 
DK-2730 Herlev Denmark 
Reviewer's report 
 Complement Activation Capacity in Plasma before and during High-dose Prednisolone Title: 
Treatment and Tapering in Exacerbations of Crohn's Disease and Ulcerative Colitis 
 2  10 April 2005 Version: Date: 
 Ole Haagen H Nielsen Reviewer: 
Reviewer's report: 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached)General This is an interesting study focusing on the complement activation capacity 
among IBD patients evaluated in plasma samples with relation to glucocorticoid treatment. It is 
revealed that complement activation capacity is upregulated in Crohn’s disease. 
Major comments: 
The complement system is often overlooked in relation to the inflammatory response seen in 
ulcerative colitis and Crohn’s disease. However, some relatively few researchers have focused deeply on this topic among others: Jens Elmgreen who defended a doctoral thesis around 15 years 
ago (not mentioned in references). 
For the general reader the authors should consider to add a little more information (some few more 
sentences in introduction) regarding the difference between the classical and alternative 
complement activation cascades. The aim should also be strengthened: why it is of interest to 
analyse an association between complement activation capacity and treatment? As a result the 
conclusion of the present paper is rather vague (e.g. “further studies are needed” and “to clarify the 
roles”). 
Which impact do the authors believe the information retrieved from the present experimental study might reach in the future clinical situation? 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the 
author can be trusted to correct)Minor comments: 1. Some logical steps are missing in the Background. As an example: Further insight into the 
complement system continues to emerge, e.g. that MBL. More focus should be attended to MBL (but 
also C4b/iC4b) than just the above mentioned sentence, as MBL seems to be rather central for the 
present paper. 2. Was any differences observed in those 10 patients still on glucocorticoid as compared to those tapered out after 12 weeks? 
3. I believe the ethical standards are in accordance with the declaration of Helsinki V. 
4. The association between the obtained results and NF-&#954;B (last sentence of Discussion section) is speculative. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
Ole Haagen Nielsen 
Associate professor, chief physician, MD, DMSc 
dept. of Gastroenterology C112 
Herlev Hospital University of Copenhagen 
Herlev Ringvej 
DK-2730 Herlev Denmark 
Please review this paper.
user
Reviewer's report 
 Complement Activation Capacity in Plasma before and during High-dose Prednisolone Title: 
Treatment and Tapering in Exacerbations of Crohn's Disease and Ulcerative Colitis 
 2  10 April 2005 Version: Date: 
 Ole Haagen H Nielsen Reviewer: 
Reviewer's report: 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached)General This is an interesting study focusing on the complement activation capacity 
among IBD patients evaluated in plasma samples with relation to glucocorticoid treatment. It is 
revealed that complement activation capacity is upregulated in Crohn’s disease. 
Major comments: 
The complement system is often overlooked in relation to the inflammatory response seen in 
ulcerative colitis and Crohn’s disease. However, some relatively few researchers have focused deeply on this topic among others: Jens Elmgreen who defended a doctoral thesis around 15 years 
ago (not mentioned in references). 
For the general reader the authors should consider to add a little more information (some few more 
sentences in introduction) regarding the difference between the classical and alternative 
complement activation cascades. The aim should also be strengthened: why it is of interest to 
analyse an association between complement activation capacity and treatment? As a result the 
conclusion of the present paper is rather vague (e.g. “further studies are needed” and “to clarify the 
roles”). 
Which impact do the authors believe the information retrieved from the present experimental study might reach in the future clinical situation? 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the 
author can be trusted to correct)Minor comments: 1. Some logical steps are missing in the Background. As an example: Further insight into the 
complement system continues to emerge, e.g. that MBL. More focus should be attended to MBL (but 
also C4b/iC4b) than just the above mentioned sentence, as MBL seems to be rather central for the 
present paper. 2. Was any differences observed in those 10 patients still on glucocorticoid as compared to those tapered out after 12 weeks? 
3. I believe the ethical standards are in accordance with the declaration of Helsinki V. 
4. The association between the obtained results and NF-&#954;B (last sentence of Discussion section) is speculative. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
Ole Haagen Nielsen 
Associate professor, chief physician, MD, DMSc 
dept. of Gastroenterology C112 
Herlev Hospital University of Copenhagen 
Herlev Ringvej 
DK-2730 Herlev Denmark 
assistant