Complement Alternative Pathway׳s Activation in Patients With Lupus Nephritis.

The aim of this study was to detect the spectrum of complement activation pathways in circulation and to assess their correlations with clinical and pathologic features in a large lupus nephritis cohort from China. Plasma levels of C1q, mannose-binding lectin, C4d, Bb, C3, C3a, C5a and soluble C5b-9 were detected by enzyme-linked immunosorbent assay in 222 patients with active biopsy-proven lupus nephritis, 34 patients with lupus nephritis at remission, 82 patients with active systemic lupus erythematosus without renal involvement and 39 normal controls. The correlations between levels of complement components and clinicopathological features of these patients were further analyzed. Plasma levels of C1q and C3 significantly decreased, and the levels of Bb, C3a, C5a and soluble C5b-9 were significantly elevated in patients with active lupus nephritis compared with those in remission, active systemic lupus erythematosus without renal involvement group and normal controls. In the lupus nephritis group, soluble C5b-9 levels were inversely correlated with C1q and C4d levels (r = -0.412, P < 0.001 and r = -0.221, P = 0.002, respectively), but more strongly correlated with the level of Bb (r = 0.546, P < 0.001). C3b, Bb and C5b-9 could colocalize on glomeruli in lupus nephritis. Plasma Bb level was significantly correlated with some renal disease activity indices and was a risk factor for renal outcomes (hazard ratio = 1.745; 95% CI: 1.106-2.754; P = 0.017) in the lupus nephritis group. Our findings suggested that the activation of the complement alternative pathway might play a more important role in the pathogenesis of lupus nephritis, and factor Bb might be a useful marker for evaluating renal disease activity and outcomes.

Song D ，Guo WY ，Wang FM ，Li YZ ，Song Y ，Yu F ，Zhao MH ... -  《-》

Sensitivity and specificity of plasma and urine complement split products as indicators of lupus disease activity.

Manzi S ，Rairie JE ，Carpenter AB ，Kelly RH ，Jagarlapudi SP ，Sereika SM ，Medsger TA Jr ，Ramsey-Goldman R ... -  《ARTHRITIS AND RHEUMATISM》

Activation of the alternative complement pathway predicts renal outcome in patients with lupus nephritis.

Kim H ，Kim T ，Kim M ，Lee HY ，Kim Y ，Kang MS ，Kim J ... -  《-》

Complement activation products in the circulation and urine of primary membranous nephropathy.

Zhang MF ，Huang J ，Zhang YM ，Qu Z ，Wang X ，Wang F ，Meng LQ ，Cheng XY ，Cui Z ，Liu G ，Zhao MH ... -  《-》

Complement activation in patients with systemic lupus erythematosus without nephritis.

Mollnes TE ，Haga HJ ，Brun JG ，Nielsen EW ，Sjöholm A ，Sturfeldt G ，Mårtensson U ，Bergh K ，Rekvig OP ... -  《RHEUMATOLOGY》