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Alternative Complement Pathway Is Activated and Associated with Galactose-Deficient IgA(1) Antibody in IgA Nephropathy Patients

BACKGROUND: Galactose-deficient IgA(1) (Gd-IgA(1)) and alternative complement pathway activation are considered to be involved in the pathogenesis of IgA nephropathy (IgAN). Nevertheless, the relationships between alternative pathway activation and disease activity or Gd-IgA(1) level remains unclear...

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Autores principales: Chiu, Yen-Ling, Lin, Wei-Chou, Shu, Kai-Hsiang, Fang, Yi-Wen, Chang, Fan-Chi, Chou, Yu-Hsiang, Wu, Ching-Fang, Chiang, Wen-Chih, Lin, Shuei-Liong, Chen, Yung-Ming, Wu, Ming-Shiou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223746/
https://www.ncbi.nlm.nih.gov/pubmed/34177889
http://dx.doi.org/10.3389/fimmu.2021.638309
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author Chiu, Yen-Ling
Lin, Wei-Chou
Shu, Kai-Hsiang
Fang, Yi-Wen
Chang, Fan-Chi
Chou, Yu-Hsiang
Wu, Ching-Fang
Chiang, Wen-Chih
Lin, Shuei-Liong
Chen, Yung-Ming
Wu, Ming-Shiou
author_facet Chiu, Yen-Ling
Lin, Wei-Chou
Shu, Kai-Hsiang
Fang, Yi-Wen
Chang, Fan-Chi
Chou, Yu-Hsiang
Wu, Ching-Fang
Chiang, Wen-Chih
Lin, Shuei-Liong
Chen, Yung-Ming
Wu, Ming-Shiou
author_sort Chiu, Yen-Ling
collection PubMed
description BACKGROUND: Galactose-deficient IgA(1) (Gd-IgA(1)) and alternative complement pathway activation are considered to be involved in the pathogenesis of IgA nephropathy (IgAN). Nevertheless, the relationships between alternative pathway activation and disease activity or Gd-IgA(1) level remains unclear. METHODS: Ninety-eight biopsy-diagnosed IgAN, twenty-five primary focal segmental sclerosis (FSGS) patients and forty-two healthy individuals were recruited in this study. Among them, fifty IgAN patients received immunosuppression. Follow-up blood samples at 1 and 3~6 months after immunosuppression were collected. Plasma levels of complement C5a, factor Ba and Gd-IgA(1) were measured and analyzed. Immunostaining for complement was performed in twenty-five IgAN and FSGS patients. RESULTS: At baseline, IgAN patients had higher levels of plasma C5a, factor Ba and Gd-IgA(1) than control subjects. Gd-IgA(1) levels positively correlated with plasma C5a and factor Ba. In addition, levels of factor Ba and Gd-IgA(1) were positively associated with proteinuria and negatively associated with renal function. Immunostaining revealed positive staining for factor Bb and C3c in glomeruli in IgAN patients, but not in FSGS patients. At baseline, patients receiving immunosuppression had more severe proteinuria and higher factor Ba. After 6 months, eGFR declined and proteinuria persisted in patients without immunosuppression. In contrast, patients who received immunosuppression exhibited decreased plasma levels of C5a, factor Ba, and Gd-IgA(1) as early as 1 month after treatment. Proteinuria decreased and renal function also remained stable 6 months after immunosuppression. CONCLUSIONS: Our results indicate a close relationship between alternative complement pathway activation, Gd-IgA(1) concentration and clinical severity of IgAN. Level of complement factor B may be a potential marker for disease activity and therapeutic target in IgAN patients.
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spelling pubmed-82237462021-06-25 Alternative Complement Pathway Is Activated and Associated with Galactose-Deficient IgA(1) Antibody in IgA Nephropathy Patients Chiu, Yen-Ling Lin, Wei-Chou Shu, Kai-Hsiang Fang, Yi-Wen Chang, Fan-Chi Chou, Yu-Hsiang Wu, Ching-Fang Chiang, Wen-Chih Lin, Shuei-Liong Chen, Yung-Ming Wu, Ming-Shiou Front Immunol Immunology BACKGROUND: Galactose-deficient IgA(1) (Gd-IgA(1)) and alternative complement pathway activation are considered to be involved in the pathogenesis of IgA nephropathy (IgAN). Nevertheless, the relationships between alternative pathway activation and disease activity or Gd-IgA(1) level remains unclear. METHODS: Ninety-eight biopsy-diagnosed IgAN, twenty-five primary focal segmental sclerosis (FSGS) patients and forty-two healthy individuals were recruited in this study. Among them, fifty IgAN patients received immunosuppression. Follow-up blood samples at 1 and 3~6 months after immunosuppression were collected. Plasma levels of complement C5a, factor Ba and Gd-IgA(1) were measured and analyzed. Immunostaining for complement was performed in twenty-five IgAN and FSGS patients. RESULTS: At baseline, IgAN patients had higher levels of plasma C5a, factor Ba and Gd-IgA(1) than control subjects. Gd-IgA(1) levels positively correlated with plasma C5a and factor Ba. In addition, levels of factor Ba and Gd-IgA(1) were positively associated with proteinuria and negatively associated with renal function. Immunostaining revealed positive staining for factor Bb and C3c in glomeruli in IgAN patients, but not in FSGS patients. At baseline, patients receiving immunosuppression had more severe proteinuria and higher factor Ba. After 6 months, eGFR declined and proteinuria persisted in patients without immunosuppression. In contrast, patients who received immunosuppression exhibited decreased plasma levels of C5a, factor Ba, and Gd-IgA(1) as early as 1 month after treatment. Proteinuria decreased and renal function also remained stable 6 months after immunosuppression. CONCLUSIONS: Our results indicate a close relationship between alternative complement pathway activation, Gd-IgA(1) concentration and clinical severity of IgAN. Level of complement factor B may be a potential marker for disease activity and therapeutic target in IgAN patients. Frontiers Media S.A. 2021-06-10 /pmc/articles/PMC8223746/ /pubmed/34177889 http://dx.doi.org/10.3389/fimmu.2021.638309 Text en Copyright © 2021 Chiu, Lin, Shu, Fang, Chang, Chou, Wu, Chiang, Lin, Chen and Wu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Chiu, Yen-Ling
Lin, Wei-Chou
Shu, Kai-Hsiang
Fang, Yi-Wen
Chang, Fan-Chi
Chou, Yu-Hsiang
Wu, Ching-Fang
Chiang, Wen-Chih
Lin, Shuei-Liong
Chen, Yung-Ming
Wu, Ming-Shiou
Alternative Complement Pathway Is Activated and Associated with Galactose-Deficient IgA(1) Antibody in IgA Nephropathy Patients
title Alternative Complement Pathway Is Activated and Associated with Galactose-Deficient IgA(1) Antibody in IgA Nephropathy Patients
title_full Alternative Complement Pathway Is Activated and Associated with Galactose-Deficient IgA(1) Antibody in IgA Nephropathy Patients
title_fullStr Alternative Complement Pathway Is Activated and Associated with Galactose-Deficient IgA(1) Antibody in IgA Nephropathy Patients
title_full_unstemmed Alternative Complement Pathway Is Activated and Associated with Galactose-Deficient IgA(1) Antibody in IgA Nephropathy Patients
title_short Alternative Complement Pathway Is Activated and Associated with Galactose-Deficient IgA(1) Antibody in IgA Nephropathy Patients
title_sort alternative complement pathway is activated and associated with galactose-deficient iga(1) antibody in iga nephropathy patients
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223746/
https://www.ncbi.nlm.nih.gov/pubmed/34177889
http://dx.doi.org/10.3389/fimmu.2021.638309
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