[Comparative characteristics of the complement system in patients with C3-glomerulopathy and atypical hemolytic uremic syndrome of chronic course who suffered an acute episode of thrombotic microangiopathy].

Autor: Yurova VA; Sechenov First Moscow State Medical University (Sechenov University)., Kozlovskaya NL; People's Friendship University of Russia (RUDN University)., Bobrova LA; Sechenov First Moscow State Medical University (Sechenov University)., Kozlov LV; Gabrichevsky Research Institute for Epidemiology and Microbiology., Andina SS; Gabrichevsky Research Institute for Epidemiology and Microbiology., Demyanova KA; People's Friendship University of Russia (RUDN University).
Jazyk: ruština
Zdroj: Terapevticheskii arkhiv [Ter Arkh] 2023 Aug 17; Vol. 95 (6), pp. 475-480. Date of Electronic Publication: 2023 Aug 17.
DOI: 10.26442/00403660.2023.06.202269
Abstrakt: Aim: To compare changes in the complement system in C3-glomerulopathy (C3-GP) and atypical hemolytic uremic syndrome (aHUS) after the relief of an acute episode of thrombotic microangiopathy.
Materials and Methods: The study included 8 patients diagnosed with C3-GP and 8 with aHUS in remission. The blood levels of the complement system components were determined: C3, C4, C3a, C5a, factor H (CFH), factor B (CFB), membrane-attacking complex (MAC), antibodies to C3b (anti-C3b-AT), the level of hemolytic activity (CH50), the content of factor D (CFD) in the urine.
Results: C3 and CH50 levels were within the reference range in both groups, however, in the C3-GP group they were at the lower limit, and C3 level was significantly lower than in the aHUS group: 0.56 [0.44; 0.96] vs 1.37 [1.16; 2.52] ( p =0.003). CFB increased level was detected in both groups, but in the C3-GP group it was significantly lower than in the aHUS group - 275.1 [222.1; 356.6] vs 438.7 [323.3; 449.3] ( p =0.010). C3a, C5a and MAC levels were increased in both groups, but the maximum was in the C3-GP group, and the MAC level in the C3-GP group was 2 times higher than that in aHUS, and these differences reached statistical significance - 123 555±6686 vs 5603±1294 ( p =0.036). CFH and CFD levels was increased in both groups, but their highest values was in the aHUS group.
Conclusion: Alternative complement pathway activation signs were present in both groups of patients with complement-mediated nephropathies, regardless the stage of the disease. In C3-GP, alternative complement pathway activation was more pronounced than in aHUS after the relief of an acute episode of thrombotic microangiopathy.
Databáze: MEDLINE