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Published on: September 1, 2015
Excessive activation of the alternative complement pathway in autosomal dominant polycystic kidney disease
1Kidney Institute, Department of Nephrology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
Insights
The complement system, specifically the alternative pathway, is implicated in autosomal dominant polycystic kidney disease (ADPKD) progression. Targeting this pathway with agents like rosmarinic acid (RMA) shows therapeutic potential for ADPKD.
Area of Science:
- Nephrology
- Immunology
- Molecular Biology
Background:
- The complement system plays a role in immune complex-mediated kidney diseases.
- Its specific involvement in autosomal dominant polycystic kidney disease (ADPKD) pathogenesis is not well understood.
Purpose of the Study:
- To investigate the role of the complement system in ADPKD.
- To explore the therapeutic potential of targeting the complement system in ADPKD.
Main Methods:
- Urine glycoproteome screening identified complement factors.
- Immunostaining and Western blot analyzed protein expression in kidney tissues.
- Pharmacological inhibition of the complement system using rosmarinic acid (RMA) in ADPKD mouse and rat models.
Main Results:
- Elevated levels of complement factor B (CFB) and complement component 9 (C9) were observed in ADPKD patients.
- CFB and C9 expression was higher in ADPKD kidneys compared to other chronic kidney diseases.
- RMA treatment significantly reduced kidney dysfunction, cystogenesis, inflammation, and fibrosis in animal models.
Conclusions:
- Excessive alternative complement pathway activation is linked to ADPKD progression.
- Therapeutic strategies targeting the complement system may offer a novel treatment for ADPKD.
Objectives:
The complement system is involved in many immune complex-mediated kidney diseases, yet its role in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD) has not been examined in detail.
Methods And Results:
Screening of the glycoproteome of urine samples from ADPKD patients revealed that levels of complement factor B (CFB), serpin peptidase inhibitor, complement component 1 inhibitor (SERPING1) and complement component 9 (C9) increased, whereas complement component 1, r subcomponent-like (C1RL), CD55 and CD59 levels decreased with disease progression. Immunostaining and Western blot analysis confirmed the enhanced expression of CFB and C9 in cystic kidneys from ADPKD patients. Immunostaining also showed that the expressions of CFB and C9 in renal biopsy tissues from patients with other types of chronic kidney disease were lower than in tissues from ADPKD patients. The effect of the complement inhibitor rosmarinic acid (RMA) was evaluated in Pkd1(-/-) mice and Han:SPRD Cy/+ rats. Compared with vehicle-treated Pkd1(-/-) animals, RMA-treated mice had significantly lower serum creatinine (-50%) and blood urea nitrogen (-78%) levels, two kidneys/body weight ratio (-60%) and renal cystic index (-60%). Similar results were found in Cy/+ rats. Lower numbers of Ki67-positive nuclei and inflammatory cells and reduced fibrosis were observed in both animal models upon treatment with RMA.
Conclusions:
These results suggest that excessive activation of the alternative complement pathway is associated with ADPKD progression, probably mediated by cyst-lining epithelial cell proliferation, tubulointerstitial inflammatory cell infiltration and fibrosis. Targeting the complement system might represent a new therapeutic strategy for ADPKD.
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