Genetic deficiency of complement factor H in a patient with age-related macular degeneration and

Tamara Montes1, Elena Goicoechea de Jorge, Rosa Ramos

  • 1Centro de Investigaciones Biológicas and Centro de Investigación Biomédica en Enfermedades Raras, Ramiro de Maeztu 9, Madrid, Spain.

Molecular Immunology
|March 14, 2008
PubMed

Insights

Age-related macular degeneration and membranoproliferative glomerulonephritis type II share a genetic link to complement genes. A novel mutation in factor H was identified, suggesting a common pathway in these dense deposit diseases.

Area of Science:

  • Genetics
  • Immunology
  • Ophthalmology
  • Nephrology

Background:

  • Age-related macular degeneration (AMD) and membranoproliferative glomerulonephritis type II (MPGN2) are rare, severe diseases characterized by dense deposits.
  • Both conditions are linked to genetic factors involving the complement system, a crucial part of the immune system.

Observation:

  • A 64-year-old male patient developed both AMD and MPGN2.
  • He exhibited low plasma C3 levels, borderline low factor H, and traces of C3NeF.
  • Genetic analysis revealed a novel mutation in the CFH gene (c.1292 G>A), leading to a Cys431Tyr substitution in factor H.

Findings:

  • The patient was a carrier of multiple genetic risk factors for AMD and MPGN2.
  • Proteomic and functional studies confirmed the absence of the mutated factor H allele in his plasma, indicating partial factor H deficiency.
  • The identified mutation and other genetic factors create a profile consistent with complement dysregulation.

Implications:

  • These findings support the hypothesis that AMD and MPGN2 share a common pathogenic mechanism.
  • Dysregulation of the alternative pathway of complement activation is implicated as the underlying cause.
  • Understanding this shared pathway could lead to new diagnostic and therapeutic strategies for dense deposit diseases.

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