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Correlations of the Complement Proteins MASP-2 and MASP-3 With Clinical Severity and Short-Term Outcomes in Primary
Tong Liu1, Miao Hu1, Yujie Bai1
1Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
Aim:
This study aimed to explore the serum levels of mannose binding lectin-associated serine protease 2(MASP-2) and 3(MASP-3) in primary membranous nephropathy (PMN) patients and its correlation with clinical activity and short-term prognosis.
Methods:
Serum levels of MASP-2, MASP-3 and C5a were measured in 72 PMN patients, 71 IgAN patients and 30 healthy controls via enzyme-linked immunosorbent assay (ELISA). Correlations between complement activation biomarkers and clinical parameters were analysed using Spearman correlation. Logistic regression analysis was used to identify risk factors for short-term clinical non-remission in PMN patients, and the predictive performance of the factors was evaluated using ROC curves and the area under the ROC curve (AUC).
Results:
Serum MASP-2 levels in the PMN group were lower than in both the healthy control and IgAN groups, while levels in the IgAN group were higher than in the healthy control group. Serum levels of MASP-3 and C5a in the PMN group were not significantly different from those in the IgAN group. Both patient groups had significantly elevated serum levels of MASP-3 and C5a compared to the healthy control group. In PMN patients, serum MASP-3 and C5a levels correlated with clinical indicators such as eGFR, serum creatinine and 24-h urinary protein. Multivariate logistic regression analysis revealed that serum anti-phospholipase A2 receptor antibody (anti-PLA2R-ab) and MASP-3 were independent risk factors for the non-remission of PMN at 12 months. The combined detection of serum MASP-3 and anti-PLA2R-ab had a greater AUC for predicting early non-remission than either factor alone.
Conclusion:
Serum MASP-3 and C5a can serve as biomarkers reflecting the clinical severity of PMN. The combined detection of serum MASP-3 and anti-PLA2R-ab will improve the prediction efficiency of PMN prognosis.
Insights
Serum mannose binding lectin-associated serine protease 3 (MASP-3) and C5a levels reflect primary membranous nephropathy (PMN) severity. Combined detection of MASP-3 and anti-PLA2R-ab improves PMN prognosis prediction.
Area of Science:
- Nephrology
- Immunology
- Complement System
Background:
- Primary membranous nephropathy (PMN) is a leading cause of nephrotic syndrome in adults.
- The complement system, particularly the lectin pathway, plays a crucial role in PMN pathogenesis.
- Mannose binding lectin-associated serine proteases (MASPs) are key components of the lectin pathway.
Purpose of the Study:
- To investigate serum levels of mannose binding lectin-associated serine protease 2 (MASP-2) and MASP-3 in PMN patients.
- To correlate MASP-2 and MASP-3 levels with clinical activity and short-term prognosis in PMN.
- To evaluate MASP-3 as a potential biomarker for PMN.
Main Methods:
- Serum MASP-2, MASP-3, and C5a levels were quantified using ELISA in 72 PMN patients, 71 IgA nephropathy (IgAN) patients, and 30 healthy controls.
- Spearman correlation analysis assessed relationships between complement biomarkers and clinical parameters.
- Logistic regression and ROC curve analysis identified risk factors for short-term non-remission in PMN.
Main Results:
- Serum MASP-2 was lower in PMN patients compared to controls and IgAN patients.
- Serum MASP-3 and C5a levels were elevated in both PMN and IgAN patients compared to controls.
- In PMN patients, MASP-3 and C5a correlated with eGFR, serum creatinine, and proteinuria. MASP-3 and anti-PLA2R-ab were independent predictors of 12-month non-remission, with combined detection improving predictive accuracy.
Conclusions:
- Serum MASP-3 and C5a levels serve as valuable biomarkers for assessing the clinical severity of PMN.
- The combined assessment of serum MASP-3 and anti-PLA2R-ab significantly enhances the prediction of PMN prognosis.
- These findings suggest potential for improved patient management and therapeutic strategies in PMN.
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