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Complement regulation in renal disease models
Abhijit Naik1, Shweta Sharma, Richard J Quigg
1Section of Nephrology, University of Chicago, Chicago, IL.
Insights
Complement regulatory proteins (CRPs) control complement system activation. Defective CRPs in kidney disease can lead to glomerular damage and thrombotic microangiopathy, highlighting their crucial role in kidney health.
Area of Science:
- Immunology and Nephrology
- Complement system biology
- Molecular and cellular mechanisms of kidney disease
Background:
- The complement system is crucial for innate and adaptive immunity.
- Complement regulatory proteins (CRPs) like factor H (fH), decay-accelerating factor, and membrane cofactor protein tightly control complement activation.
- Dysregulation of CRPs is implicated in various kidney diseases.
Purpose of the Study:
- To elucidate the roles of complement regulatory proteins (CRPs) in kidney pathophysiology.
- To understand how CRP deficiencies contribute to distinct kidney pathologies.
- To explore the interplay between CRPs and different complement pathways in glomerular diseases.
Main Methods:
- Analysis of animal models with genetic deficiencies or alterations in specific CRPs (e.g., fH, Crry).
- Investigation of complement activation patterns (fluid phase vs. local) in response to CRP defects.
- Correlation of complement dysregulation with specific kidney pathologies such as dense deposit disease, thrombotic microangiopathy, and tubulointerstitial nephritis.
Main Results:
- Mice lacking fH exhibit excessive C3 activation and deposition in glomerular capillary walls (GCW), mimicking dense deposit disease.
- Altered fH targeting leads to local GCW activation and thrombotic microangiopathy.
- Defective Crry causes alternative pathway dysregulation in the tubulointerstitium, resulting in TMA, acute kidney injury, and nephritis.
Conclusions:
- CRPs are critical for preventing excessive complement activation in the kidney.
- Defective CRPs, particularly fH in the GCW and Crry in the tubulointerstitium, precipitate distinct kidney pathologies.
- Acquired alterations in CRPs, potentially due to cellular injury or autoantibodies, are common and influence disease development.
Abstract:
Activation of the complement system is tightly regulated by plasma and cell-associated complement regulatory proteins (CRPs), such as factor H (fH), decay-accelerating factor, and membrane cofactor protein. Animal models of disease have provided considerable insights into the important roles for CRPs in the kidney. Mice deficient in fH have excessive fluid phase C3 activation and inactivation, leading to deposition of inactivated C3b in glomerular capillary walls (GCW), comparable with dense deposit disease. In contrast, when fH lacks C-terminal surface targeting regions, local activation on the GCW leads to a disease reminiscent of thrombotic microangiopathy. The uniquely rodent protein, CR1-related y (Crry), has features analogous to human membrane cofactor protein. Defective Crry leads to unrestricted alternative pathway activation in the tubulointerstitium, resulting in pathologic features ranging from thrombotic microangiopathy (TMA), acute kidney injury, and tubulointerstitium nephritis. In the presence of initiators of the classic or lectin pathways, commonly in the form of immune complexes in human glomerular diseases, complement regulation is stressed, with the potential for recruitment of the spontaneously active alternative pathway. The threshold for this activation is set by CRPs; pathology is more likely when complement regulation is defective. Within the endocapillary region of the GCW, fH is key, while decay-accelerating factor and Crry are protective on mesangial cells and podocytes. Arguably, acquired alterations in these CRPs is a more common event, extending from pathologic states of cellular injury or production of inhibitory antibodies, to physiological fine tuning of the adaptive immune response.
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