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The complement cascade and renal disease

Katarzyna Kościelska-Kasprzak1, Dorota Bartoszek, Marta Myszka

  • 1Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland, katarzynakoscielska@interia.pl.

Archivum Immunologiae Et Therapiae Experimentalis
|September 14, 2013
PubMed

Insights

The complement cascade, crucial for immunity, also drives kidney diseases like lupus nephritis and transplant rejection. Understanding its role and genetics offers new therapeutic targets for these conditions.

Area of Science:

  • Immunology
  • Nephrology
  • Pathology

Background:

  • The serum complement cascade is a key part of innate immunity, protecting against pathogens.
  • Dysregulation of the complement system contributes to various diseases and injuries.
  • Complement activation involves classical, lectin, and alternative pathways, culminating in the membrane attack complex.

Purpose of the Study:

  • To review the involvement of the complement cascade in kidney disease pathogenesis and injury.
  • To discuss the role of complement pathways in specific glomerulonephritis forms, C3 glomerulopathy, and hemolytic uremic syndrome.
  • To explore genetic factors in complement dysregulation and potential therapeutic strategies.

Main Methods:

  • Literature review of complement cascade involvement in renal pathology.
  • Analysis of complement pathways in autoimmune and non-autoimmune kidney diseases.
  • Examination of genetic underpinnings and therapeutic interventions for complement-mediated kidney disorders.

Main Results:

  • The complement cascade is implicated in lupus nephritis, anti-GBM disease, ANCA-associated GN, C3 glomerulopathy, HUS, and renal allograft rejection.
  • Disturbances in complement activation and regulation, linked to genetics, correlate with observed kidney pathology.
  • Anaphylatoxins C3a and C5a mediate effects on immune and non-immune cells in disease states.

Conclusions:

  • The complement system plays a significant role in the pathogenesis of diverse kidney diseases.
  • Understanding complement dysregulation and genetics is crucial for diagnosing and treating these conditions.
  • Targeting the complement system presents promising therapeutic avenues for complement-related kidney disorders.

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