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[Role of complement in experimental glomerulonephritis].

The complement system is composed by 26 plasmatic proteins. The activation of either the classical or alternative complement pathway leads to the formation of the membrane attack complex C5b-C9 (MAC) which is capable of producing damage of the cellular membrane. MAC has been identified in renal biopsies from human and experimental, immune and nonimmune renal diseases, but it has not been possible to demonstrate any enzymatic activity on the glomerular basement membrane components (GBM). MAC can produce a lytic or a nonlytic effect on renal cells depending upon the dose used. The lytic effect in vitro has been demonstrated in epithelial, mesangial and endothelial cells, whereas the lytic effect in vivo has been described in a model of acute glomerulonephritis produced by the administration of monoclonal antibody anti-Thy 1.1. which reacts with mesangial cells. The nonlytic effect of MAC on renal cells is characterized by alterations in cell metabolism which can lead the production of prostaglandins, type IV collagen, reactive oxygen species, and a growth factor resembling interleukin I which can contribute to glomerular damage, to the modification of the filtration barrier permeability and hemodynamic changes in experimental glomerulonephritis. The effector mechanisms by which the complement system participates in the pathogenesis of glomerulonephritis are different in the various experimental models of nephritis. In nephrotoxic nephritis the complement pathway participates at least in 3 different ways: a) complement-neutrophil mediated injury, b) MAC dependent mechanism and c) producing hemodynamic alterations. In acute serum sickness the complement system beyond C2 is not necessary for the development of proteinuria and glomerular inflammation, but the MAC assembly seems to be important for the formation of large deposits. In the chronic serum sickness model, the complement system participates in the early proteinuria as well as in the histological expression of the disease. In the heterologous phase of Heymann's nephritis, the proteinuria is complement dependent whereas in the autologous phase the damage depends upon cellular mediated immunity. In passive Heymann's nephritis the complement system and particularly MAC, has a central role for the histological lesion of the epithelial cell as well as in the proteinuria. In conclusion, the complement system can mediate renal damage by the following mechanism: a) Releasing chemotactic factors which result in neutrophil recruitment and neutrophil mediated glomerular damage.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Lupus erythematosus panniculitis with partial genetic deficiency of C2 and C4 in a child.

A 7-year-old girl developed recurrent febrile nodules and subcutaneous plaques on her arm, shoulder, and face. Primary acquired toxoplasmosis was diagnosed at onset, because of associated lymphadenopathy and detection of specific IgM. Skin lesions were responsive to therapy with systemic steroids but progressed to atrophy and poikiloderma within a few months. Subsequently, chloroquine therapy has been instituted and no relapse has occurred. Histopathologic findings and direct immunofluorescence studies were diagnostic of lupus erythematosus panniculitis. Electron microscopy showed lamellar inclusions within mast cells. Results of laboratory investigations disclosed leukopenia and hypocomplementemia with low C2 serum levels. A family study of the complement system, including C4 and Bf phenotyping and HLA A, B, and DR haplotyping, revealed the carriage of both C2 and C4A null alleles in the propositus. This observation suggests an additional link between lupus erythematosus panniculitis and the remainder of the lupus erythematosus clinical spectrum.

Adolescent↗

Activation of the alternative pathway of complement by Entamoeba histolytica.

A cytopathogenic effect was observed when Entamoeba histolytica was exposed to human sera from individuals with no clinical history or laboratory evidence of amoebiasis. Absorption studies showed that the effect was not due to natural antibodies. Studies performed using ethylenediamine tetracetic acid (EDTA), cobra venom factor (CoF) and heat-inactivation at 56 degrees C, indicated that the cytopathogenic effect was complement dependent. Furthermore, by using ethylene glycol tetracetic acid (EGTA) and Mg++, zymosan, heat-inactivation at 50 degrees C to destroy the activity of factor B of the alternative pathway, as well as electrophoretic studies with anti-human factor B, it was possible to determine that E. histolytica activated the properdin pathway. Finally, complement determinations indicated that incubation of E. histolytica with normal human serum consumed complement. The diminution in CH50 correlated with a consumption of C3 but not of C1, C4 and C2. It was concluded from these results that trophozoites of E. histolytica activate the alternative pathway of the human complement system.

Animals↗

Distribution of hemolytic complement in the normal cornea.

Hemolytic activities in the central cornea were compared with hemolytic activities in the peripheral cornea for each of the following complement components: C1, C4, C2, C3, C5, C6, and C7. For all seven complement components studied, hemolytic activities in the peripheral cornea were higher than hemolytic activities in the central cornea, and the differences were statistically significant. The most striking difference was for C1, which had a ratio of mean hemolytic activity in the peripheral cornea to that in the central cornea of almost 5:1. For the other six complement components, the ratio of the mean hemolytic activity in the peripheral cornea to that in the central cornea was approximately 1.2:1. This distribution of complement activity in the cornea suggests that the major source of complement components is the limbal vessels and that complement components diffuse from the limbus to the central cornea.

Aged↗

[C2 deficiency discovered in pneumococcal meningitis].

BACKGROUND: Congenital deficiencies of complement system proteins are rare. Patients with C2 deficiency have a high incidence of vascularitis syndromes. Most patients with this deficiency have no problems with increased susceptibility to infection, most commonly due to pneumococci, presumably because of the protective function of the alternative pathway. CASE REPORT: A 22 month-old girl was admitted because of acute meningitis and otitis. She had had 2 episodes of otitis media at the age of 1 year. Analysis of the CSF showed that this meningitis was due to pneumococcal infection. Recovery was complete after 15 days of antibiotic therapy. Total hemolytic complement activity (CH50) was low during the infection; one month later, the CH50 value was about zero as was C2, while C3 and C4 were normal. The patient was given polyvalent pneumococcal and anti-Haemophilus vaccines plus prophylactic penicillin G. Laboratory tests for systemic lupus erythematosus were negative. CONCLUSION: A defect of complement function should be suspected in any patient with severe of recurring pyogenic infections. Complement disorders can be detected one month later by means of the relatively simple hemolytic complement assay.

Complement C2↗

Phylogeny of SINE-R retroposons in Asian apes.

The SINE-R retroposon family was derived from the long terminal repeats (LTRs) of human endogenous retrovirus K (HERV-K) that had been active during the hominoid evolution. The retroposons and HERV-K LTR elements have potential relevance to structural change and genetic variation of the hominoid genome. In our previous study, we found that the SINE-R retroposons were hominoid specific. Here we identified seventeen new SINE-R retroposons (14 from orangutan and 3 from gibbon) from Asian apes and phylogenetically analysed them in comparison with those of the humans and African great apes. None of the retroposons from Asian apes were closely related to SINE-R.C2 that is human specific, and originally identified in the gene for the C2 component of complement, whereas some retroposons (Ch-M10, Ch-M16, Gor-M, Gor-F1, Gor-M6, and Gor-F9) from African great apes showed very close relationship with that of the SINE-R.C2 retroposon. The phylogenetic tree based on the SINE-R retroposons revealed wide overlap of the retroposons across species, suggesting that the SINE-R retroposons have been evolved parallel pattern in the course of hominoid evolution.

Animals↗

The role of adhesion molecules in the regulation of antibody responses.

We used the T-cell-dependent antigen, bacteriophage (phage) phi X174, to study antibody synthesis in patients, guinea pigs, and dogs with complement component deficiencies (C2, C4, C3, C7); in patients with adhesion molecule deficiencies (CD11/CD18 or sialylated Lewisx); and in patients with the hyper IgM (HIM) syndrome (absence of functional gp39 expression by activated T cells). Patients and guinea pigs deficient in early complement components, patients deficient in CD11/CD18, and patients lacking functional gp39 on activated T cells responded to repeated phage immunizations with depressed antibody titers, lack of or inadequate amplification, and failure to switch from IgM to IgG, suggesting that defective T-cell-B-cell interaction is the cause of the antibody deficiency observed in these patients.

Animals↗

Multiple sclerosis in north-east Scotland. An association with HLA-DQw1.

This study reports the frequencies of HLA antigens and the polymorphic variants of C4, C2, and Bf for 200 patients with multiple sclerosis (MS) living in the Grampian region of Scotland, an area of high disease prevalence. A group of 128 normal subjects from the same region were typed for comparison. Although the frequencies of HLA-B7 and DR2 in the patient group (43.3% and 49.4%, respectively) were found to be similar to those reported for other Northern European HLA studies on patients with MS, high frequencies of these antigens were also observed in the group of normal Grampian subjects (38.3% and 40.6%) the differences were not statistically significant. However, a significant association was found between the recently defined Class II HLA antigen, DQw1, and MS (P less than 0.006) when compared with controls. There were no significant differences in frequency of the polymorphisms of C4, C2, and Bf when the group of patients with MS was compared with the control group of normal subjects. The patients were subdivided according to disease severity, remittent versus progressive clinical course, age of onset of the disease and initial symptoms. The frequencies of the HLA and complement polymorphisms (C4, C2, and Bf) were analysed in these subdivisions. DQw1 was found with similar frequency in severe and benign disease (78% and 80%, respectively) but DR2 was most frequent in the group of patients with remittent disease (54%). There were no significant differences in frequency of the polymorphisms of C4, C2, and Bf between the above subgroups of patients and overall no significant HLA associations were found with age of onset of disease or initial symptoms. The findings suggest that in an area of high prevalence of MS, the disease is more closely associated with DQw1 than DR2. Furthermore, there was no evidence to support the hypothesis that the HLA region complement gene polymorphisms show significant association with a putative HLA-linked MS susceptibility gene.

Complement C4↗

Complement determinations in the synovial fluid and serum of a patient with Erythema nodosum leprosum.

Simultaneous serum and synovial fluid CH50, C1, C4, C2, C1 esterase inhibitor and C3 protein were determined in a patient with acute erythema nodosum leprosum. The pattern of synovial fluid complement activity coupled with the demonstration of multiple lepra bacilli free and within histiocytes is more consistent with an infectious than an immune complex induced synovitis.

Arthritis, Infectious↗

Classical and alternative pathway complement activation are not required for reactive systemic AA amyloid deposition in mice.

During induction of reactive systemic amyloid A protein (AA) amyloidosis in mice, either by chronic inflammation or by severe acute inflammation following injection of amyloid enhancing factor, the earliest deposits form in a perifollicular distribution in the spleen. Because the splenic follicular localization of immune complexes and of the scrapie agent are both complement dependent in mice, we investigated the possible complement dependence of AA amyloid deposition. In preliminary experiments, substantial depletion of circulating C3 by cobra venom factor had little effect on experimental amyloid deposition. More importantly, mice with targeted deletion of the genes for C1q or for both factor B and C2, and therefore unable to sustain activation, respectively, of either the classical complement pathway or both the classical and alternative pathways, showed amyloid deposition similar to wild type controls. Complement activation by either the classical or alternative pathways is thus not apparently necessary for the experimental induction of systemic AA amyloid in mice.

Amyloidosis↗

Complement activation by isolated myelin: activation of the classical pathway in the absence of myelin-specific antibodies.

Many pathological conditions of the central nervous system involve damage to and removal of myelin membrane. Very little is known about initiation of this membrane damage and the mechanisms of disposal of the damaged tissue. We are interested in the interaction between complement (the components of complement are designated C1, C2, C3, etc.) and myelin membranes and the possible role of complement in amplifying myelin damage and in the disposal of damaged myelin in vivo, because activation of complement generates both membrane-attack complexes and opsonin(s). In this study, we found that isolated rat or human myelin consumes complement in the absence of specific antibodies. Activation of complement was demonstrated by showing C3 cleavage in fresh serum incubated with myelin. Incubation of central nervous system myelin with C2-deficient serum produced no C3 consumption and only minor factor B conversion, thus excluding the alternative pathway of activation. Involvement of the classical pathway was shown directly by the C1 fixation and transfer assay. Myelin incubated with C2-deficient serum or with purified C1 and then washed contained C1 activity that could lyse sheep erythrocytes sensitized with anti-Forssman IgM antibody and carrying C4, together with C2 and C3-C9. Membranes in brain tissues other than myelin (heavy membrane fraction obtained on sucrose density gradient centrifugation) were unable to activate C1.

Animals↗

Immune complexes and complement components in Bell's palsy.

The serum levels of circulating immune complexes were studied in 63 patients and the complement system in 36 patients with Bell's palsy. The IgG-C1q and IgG-C3 containing immune complexes were analyzed by an enzyme-linked immunosorbent assay. The levels were found to be significantly elevated in the acute and convalescent stages of the palsy compared with controls. The total complement activity as determined by a CH50 assay and complement component C3 titrations also showed elevated values. The levels of C2 were not altered. The results indicate in Bell's palsy an inflammatory process and an antigen-antibody response which may be triggered by a viral antigen.

Adolescent↗

Participation of immunoglobulin and the alternative complement pathway in opsonization of Bacteroides fragilis and Bacteroides thetaiotaomicron.

Studies were conducted to determine the requirements for immunoglobulin and complement for opsonization of Bacteroides fragilis and Bacteroides thetaiotaomicron. The ability of human sera depleted of immunoglobulin or complement components to promote phagocytosis and intracellular killing of the strains of Bacteroides by human leukocytes was measured in vitro under anaerobic conditions. Neither hypogammaglobulinemic sera nor pooled normal human serum (PNHS) heated at 56 C for 30 min supported phagocytosis and killing of the strains of Bacteroides. Sera depleted of terminal complement components by treatment with inulin or cobra venom factor and C8-deficient human serum did not support phagocytosis of the test strains. PNHS depleted of C3, factor B, or factor D also did not support phagocytosis of either strain. Dose-dependent restoration of the opsonic activity of factor B-depleted serum was accomplished by purified human factor B but not by human C2. The results indicated that immunoglobulin and components of the alternative complement pathway participate in opsonization of the strains of Bacteroides tested in this study.

Agammaglobulinemia↗

Class III alleles and high-risk MHC haplotypes in type I diabetes mellitus, Graves' disease and Hashimoto's thyroiditis.

By typing a large quantity of family-based material for HLA-B, HLA-DR, C4, C2 and factor B, we were able to derive four-gene complement haplotypes (C4A, C4B, C2, BF) and six-gene MHC haplotypes (HLA-B, complement, HLA-DR). Fourteen six-gene MHC haplotypes showed linkage disequilibrium but exact frequencies could not be determined because it was not always possible to assign null C4 alleles in families where null genes were not clearly seen to segregate. Comparison of unrelated type I diabetes, Graves' disease and Hashimoto's thyroiditis patients with healthy unrelated controls revealed the following MHC allele associations: C4B*3, HLA-DR3 and HLA-DR4 with type I diabetes; BF*F1 and HLA-DR3 with Graves' disease; HLA-DR4 with Hashimoto's thyroiditis. By typing families of type I diabetes and Graves' disease patients we were able to derive two high-risk DR3+ MHC haplotypes for both type I diabetes and Graves' disease. These are HLA-B8 C4A*Q0 C4B*1 BF*S HLA-DR3 and HLA-B18 C4A*3 C4B*Q0 BF*F1 HLA-DR3, and these haplotypes account for most of the associations between these diseases and HLA-DR3. The MHC haplotype HLA-B15 C4A*3 C4B*3 BF*S HLA-DR4 also carries high risk for type I diabetes in this group of patients. Our data suggest that other DR4+ haplotypes, probably containing C4A*3 C4B*1, carry increased risk for type I diabetes whereas haplotypes containing DR4 and C4 C4A*3 C4B*Q0 do not. Our phenotype data suggest that DR4 in Hashimoto's thyroiditis is frequently associated with HLA-B44, C4A*3, C4B*1 and BF*S.

Alleles↗

Cyclophosphamide and cortisone acetate inhibit complement biosynthesis by guinea pig bronchoalveolar macrophages.

To explore mechanisms of drug-induced alterations in local host defenses in the lung, the capacity of guinea pig alveolar macrophages to synthesize the second (C2) and fourth (C4) components of complement was studied following treatment with cyclophosphamide and cortisone acetate. Administration of either drug significantly inhibited biosynthesis of C2 and C4 within 1 day. After 1 week of treatment, local complement synthesis was inhibited approximately 80%, although serum levels of the corresponding proteins were normal.

Animals↗

Expression of the MHC class III genes.

The second (C2) and fourth (C4) components of complement and factor B (B) are coded for by genes within the major histocompatibility complex (MHC). These proteins are synthesized in liver and in extrahepatic mononuclear phagocytes. The isolation of complementary DNA probes corresponding to each of these proteins now permits analysis of the molecular mechanisms controlling expression of the class III MHC genes. Genetic control of C4 gene expression has been examined in two model systems. A defect in post transcriptional processing of C4-specific RNA accounts for a failure to generate mature C4 mRNA in homozygous deficients of a C4 deficient guinea-pig strain. On the other hand, a quantitative difference in the amounts of mature C4 liver mRNA accounts for the genetic variation in C4 levels observed among several mouse strains. The maturation of monocytes to macrophages results in changes in biosynthesis of the MHC class III products; for example, a significant increase in rate of secretion of C2 and B is noted in human monocytes during the first 3 d in culture and the proportion of C2-producing cells is greater in freshly isolated macrophages than in monocytes. Macrophages demonstrate selective increases in factor B and C2 mRNA characteristic of specific tissues. In the guinea-pig macrophage, C4 gene expression is regulated by a selective feedback mechanism induced by extracellular native C4. The C4 binds to the macrophage cell surface mediating a change in transcription or, less likely, a change in stability of C4 mRNA. Regulation of C4 synthesis in the mouse macrophage is accomplished by mechanisms that are independent of this feedback control but the murine cells also display separate mechanisms for regulation of C4 and factor B-specific mRNA levels. Resident and elicited macrophages from either mouse or guinea-pig differ with respect to expression of the class III MHC gene products. These studies form the basis for evaluating the molecular regulation of inflammation, maturation of mononuclear phagocytes and the genetic variants and deficiencies of complement proteins.

Animals↗