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High Level of Serum Complement C3 Expression is Associated with Postoperative Vasculopathy Progression in Moyamoya
Min-Jie Wang1,2,3, Jiayu Wang4, Houdi Zhang2,3
1Chinese PLA Medical School, Beijing, People's Republic of China.
Background:
The immune system plays an important role in the onset and development of moyamoya disease (MMD), but the specific mechanisms remain unclear. This study aimed to explore the relationship between the expression of complements and immunoglobulin in serum and progression of MMD.
Methods:
A total of 84 patients with MMD and 70 healthy individuals were enrolled. Serum immunoglobulin and complement C3 and C4 expression were compared between healthy individuals and MMD patients. Follow-up was performed at least 6 months post-operation. Univariate and multivariate analysis after adjusting different covariates were performed to explore predictive factors associated with vasculopathy progression. A nomogram basing on the results of multivariate analysis was established to predict vasculopathy progression.
Results:
Compared to healthy individuals, MMD patients had significantly lower expression of serum complements C3 (P = 0.003*). Among MMD patients, C3 was significantly lower in those with late-stage disease (P = 0.001*). Of 84 patients, 27/84 (32.1%) patients presented with vasculopathy progression within a median follow-up time of 13.0 months. Age (P=0.006*), diastolic blood pressure (P=0.004*) and serum complement C3 expression (P=0.015*) were associated with vasculopathy progression after adjusting different covariables.
Conclusion:
Complement C3 is downregulated in moyamoya disease and decreases even further in late-Suzuki stage disease. Age, diastolic blood pressure and serum complement C3 expression are associated with vasculopathy progression, suggesting that the complement might be involved in the development of moyamoya disease.
Insights
Complement C3 levels are lower in moyamoya disease patients and decrease with disease progression. Lower C3, age, and blood pressure predict moyamoya disease progression.
Area of Science:
- Immunology
- Neurology
- Vascular Biology
Background:
- Moyamoya disease (MMD) involves the immune system, but mechanisms are unclear.
- This study investigates serum complement and immunoglobulin in MMD progression.
Purpose of the Study:
- To explore the relationship between serum complement/immunoglobulin levels and MMD progression.
- To identify predictive factors for vasculopathy progression in MMD patients.
Main Methods:
- Compared serum immunoglobulin and complement C3/C4 in 84 MMD patients and 70 controls.
- Followed patients for at least 6 months post-operation.
- Used univariate/multivariate analysis and developed a nomogram for progression prediction.
Main Results:
- MMD patients showed significantly lower serum complement C3 than controls (P=0.003).
- C3 levels were lower in late-stage MMD patients (P=0.001).
- Age, diastolic blood pressure, and C3 levels predicted vasculopathy progression (P<0.05).
Conclusions:
- Complement C3 is downregulated in MMD, decreasing further in advanced stages.
- C3, age, and diastolic blood pressure are associated with MMD vasculopathy progression.
- Complement C3 may play a role in moyamoya disease development.
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