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PubMed1990

Systemic lupus erythematosus in a patient with partial lipodystrophy.

Systemic lupus erythematosus developed in a 35-year-old woman who had partial lipodystrophy since she was 7 years old. To our knowledge, this association has been reported only once. She also had hypocomplementemia, mesangiocapillary glomerulonephritis type II, and a serum assay with positive results for C3 nephritic factor. The association of partial lipodystrophy with other autoimmune disorders suggests an immunologic pathogenesis for this disease.

Adult↗
PubMed1977

[Anticomplement activity of a polyanion: pentosan sulfuric polyester. III. Mechanism of functional inactivation of the different properdin and complement system fractions].

In vitro, the drug pentosan-poly-sulfoester (PPS) changes the electrophoretic migration of different proteins from the complement and properdin systems, such as native C3 (beta 1C globulin), C3c (beta-1A globulin), C3d (alpha-2D globulin), C1s inactivator (ClsINA), Clq and properdin factor B (B). Their more anodal migration is the consequence of a molecular alteration and persists after prolonged dialysis. These structural changes, yet undefined, explain the loss of functional activity of these proteins, and the anticomplementary activity of this drug. Moreover, PPS is able to block the alternate pathway activation by its action on properdin factor B (C3 proactivator). In fact, in presence of PPS, the activators of the properdin systems such as C3 nephritic factor are inactive. These altered mobilities are also responsible for the overestimation in the antigenic concentration of B (+ 45%), C4 (+27%) and C3/C3c (+ 14%), found in human serum containing 50 mg/ml of PPS. PPS has an original action upon the complement and properdin systems, which allows its clinical use as a potent inhibitor of the humoral mediators of inflammation.

Binding Sites↗
PubMed1988

Inhibition of immune complex solubilization by sera of patients with membranoproliferative glomerulonephritis.

Inhibition of complement mediated solubilization (CMS) of preformed immune complexes was previously demonstrated in the serum of patients with systemic lupus erythematosus. We studied the ability of serum from patients with MPGN I or III to inhibit the solubilization of preformed BSA- anti-BSA aggregates by pooled normal human serum. Inhibition of CMS was found in the sera of 20/35 patients; the inhibition was more dramatic in those with active disease (9/9), as compared to those in remission (8/21) or with renal failure (3/5). The inhibition did not seem to be related to corticosteroid therapy, nephrotic syndrome, circulating immune complexes or hypocomplementaemia. In only one patient was inhibition associated with the presence of C3 nephritic factor activity and decomplementation of the target serum.

Adolescent↗
PubMed1988

A factor activating complement via the alternative pathway in the supernatants of B cell lines transformed by Epstein-Barr virus and in sera obtained from patients with systemic lupus erythematosus.

Serum factors activating the alternative pathway of the complement (APC) were detected in 5 of 14 patients with systemic lupus erythematosus (SLE). Epstein-Barr virus (EBV)-transformed B cell lines were subsequently established from these patients and 6 of these produced factors capable of activating the APC. Using a limiting dilution technique, we obtained a clone which was producing a factor activating the APC (AF); by affinity column fractionation and polyacrylamide gel electrophoresis, the AF was found to have heavy and light chains comparable to those of normal human IgG. Normal human serum exhibited C3 split products (demonstrated by immunoelectrophoresis) in the presence of AF and under conditions permitting activation of the APC. Sera devoid of factor B, but not of C2 and C4, failed to catabolize C3 in the presence of AF. The AF failed to stabilize erythrocyte-bound C3bBb or C4b2a convertases, indicating that it was not a nephritic-factor-like molecule. We conclude that IgG molecules present in the sera and produced by EBV-transformed B cell lines from patients with SLE are apparently responsible, at least partially, for complement consumption in these patients.

B-Lymphocytes↗
PubMed1977

Partial lipodystrophy, C3 nephritic factor and clinically inapparent mesangiocapillary glomerulonephritis.

A case of partial lipodystrophy with C3 nephritic factor was found to be associated with mesangiocapillary glomerulonephritis although all clinical parameters of renal function were normal. Diagnosis of mesangiocapillary glomerulonephritis required renal biopsy. Nephriti factor obtained from this patient was immunochemically related to nephritic factor isolated from the serum of patients with typical mesangiocapillary glomerulonephritis without partial lipodystrophy.

Adult↗
PubMed1982

The patterns of glomerulonephritis in "Tjikini" Hospital Jakarta.

A pattern of primary glomerulonephritis (GN), derived from 94 patients admitted to Tjikini Hospital Jakarta, between 1976-1980 is presented. The ratio of male to female patients was 1:1.2 with mean age of 25.9 and 27.1 years respectively. The morphologic types of glomerulonephritis were analysed. This paper presents data on sex distribution, mean age, onset before hospitalisation, serum immunoglobulin, C3 complement, immunohistological deposits and clinical features. Serum Ig G levels were increased in all types of nephritis except Focal and Segmental GN. Diffuse Mesangial Proliferative (DMesP) GN was associated with a high frequency of Ig M deposits. Distribution of the different types of GN and clinical presentation were compared with other series. DMesP GN and MCGN accounted for 77% of Acute Nephritic Syndrome. It seems to be universal that the most common clinical presentation of GN patients is Nephrotic Syndrome.

Adult↗
PubMed1992

Activation of the alternative pathway of complement by monoclonal lambda light chains in membranoproliferative glomerulonephritis.

Immunopathological evidence suggests that activation of the alternative pathway of complement (AP) is involved in membranoproliferative glomerulonephritis (MPGN) and in immunoglobulin A nephropathy. In this report we describe an AP dysfunction-associated factor that was isolated from the serum and urine of a patient with hypocomplementemic MPGN. Extensive glomerular deposits of C3, properdin, and of the terminal complement components were observed in the kidney of the patient. In her serum the AP hemolytic activity was virtually absent. When mixed with fresh normal serum, the patient's serum induced a 96% C3 conversion during a 30-min incubation at +37 degrees C. This activity was found to be due to a circulating factor that by immunochemical characterization proved to be a 46-kD monoclonal immunoglobulin lambda light (L) chain dimer (lambda L). Purified lambda L, but not control lambda or kappa L chains from patients with L chain disease, activated the AP in a dose- and ionic strength-dependent manner. Functionally, lambda L was differentiated from C3 nephritic factor (an autoantibody against the AP C3 convertase, C3bBb) by its inability to bind to and stabilize the C3bBb enzyme. Instead, lambda L was observed to interact directly with the AP control factor H. Thus, lambda L represents a novel type of immunoglobulin-related AP-activating factor with the capacity to initiate alternative complement pathway activation in the fluid phase.

Antibodies, Monoclonal↗
PubMed1986

H deficiency in two brothers with atypical dense intramembranous deposit disease.

We report an H deficiency in two Algerian brothers who had early-onset glomerulonephritis. In addition, one suffered from serious lung infections. The H deficiency was defined by undetectable CH50 and AP50, and low levels of H, C3 and B (less than 10% of normal levels). I and classical pathway components, including C4-bp were normal. CR1 was present on both patients' erythrocytes. No nephritic factor or other circulating alternative pathway activator was detected. The parents, who are first cousins, and a healthy brother and sister had half-normal levels of H. These findings favor an autosomal recessive transmission of the H defect. Although by electron microscopy renal biopsies from both patients were typical for dense intramembranous deposit disease, immunofluorescence microscopy showed an atypical pattern with abundant granular C3 deposits within the mesangium and along the capillary walls. Alternative pathway activators, possibly related to dense deposits, may allow the formation of membrane-associated C3/C5 convertases, unusually stable in the absence of H, since C5, C6, C7, C8 and C9 levels were decreased in both patients. This observation may represent an interesting clue to the relationship between nephritic factor, alternative pathway activation, and dense intramembranous deposit disease.

Adolescent↗
PubMed1976

Complement activation in semi-solid medium: Insolubilization of properdin and the third component of complement (C3) in agar gels.

Although the role of properdin in the alternative pathway of complement activation remains unclear, evidence has recently been obtained for the formation of complexes between properdin and other components, including C3. In this study such complexes have apparently been directly visualized. When normal human serum and properdin were allowed to diffuse toward each other in agar gel for 16 hr, a line of precipitation could be seen when stained with Coomassie brilliant blue. The reaction occured at pH 8.6 in 0.05 M Veronal buffer at room temperature but not under physiologic conditions of pH or tonicity. Like the alternative pathway, the reaction was Me++ dependent, occurred with C2- or C5-deficient or hypogammaglobulinemic serum, and did not occur with aged, 52 degrees C-inactivated, C3b inactivator-deficient, or C3-deficient serum. 125I-labeled C3 and properdin but not Factor B were incorporated in the precipitate. Eleven sera containing the C3 nephritic factor failed to produce a precipitate with properdin, but a line of precipitation occurred between seven of these sera and normal serum. This line showed identity with the line occurring between properdin and normal serum. The phenomenon appears to result from formation of insoluble complexes between proteins of the alternative pathway and agar.

Agar↗
PubMed1987

Clinical evaluation and characterization of a unique C3 breakdown factor detected in a patient with acute glomerulonephritis.

A unique factor causing breakdown of the third component of complement (C3) was detected in a patient with acute glomerulonephritis (AGN). The activity was detected by conversion of C3 in a mixture with normal human serum using crossed immunoelectrophoresis. This factor capable of C3 breakdown was not blocked in the presence of ethylenediaminetetraacetic acid (EDTA), heat-pretreatment (56 degrees C, 30 min) und dialysis against 0.1 M phenylmethylsulfonyl fluoride (PMSF). The factor was isolated and characterized by immunochemical and physicochemical techniques. It had beta-mobility on electrophoresis and was separated at a lighter sedimentation coefficient than 7S by sucrose density gradient ultracentrifugation. The activity was absorbed on a DEAE-cellulose column and was eluted under definite conditions of relative salt concentration. These data appear to suggest that this factor is distinct from C3 nephritic factor (C3NeF), immunoglobulins, immune complexes, and other C3 convertases previously described. Moreover, it is clear that the factor was mainly responsible for the C3 activation observed in the patient with acute glomerulonephritis.

Acute Disease↗
PubMed1985

Complement activation by circulating serum factors in human glomerulonephritis.

Factors with the ability to induce a minimum of 20% C3 conversion in normal human serum (NHS) were demonstrated in the sera of nine glomerulonephritis (GN) patients. The nature of these factors was heterogeneous allowing their division into at least three different groups. First, in three cases (membranoproliferative or acute GN) they exhibited the characteristics of C3 nephritic factor, an IgG autoantibody stabilizing the alternative pathway (AP) C3 convertase, C3bBb. Secondly, the serum of one patient (SLE like syndrome, mixed cryoglobulinaemia) with an activator of both pathways and profound hypocomplementaemia showed a temperature-dependent precipitation against autologous and homologous polyclonal IgG. Immunochemical analysis suggested this activity to be due to a monoclonal IgM kappa rheumatoid factor. By gel filtration the C3 converting activity was found in the high molecular weight fractions containing the cryoprecipitable IgM-IgG complexes. Finally, in five cases the exact nature of C-activating factors remained unknown. In four of these the factors were heat labile (30 min at 54 degrees C) C activators in association with post-streptococcal glomerulonephritis. The results suggest that the various C activating factors, possibly distinct from 'classical' immune complexes, are indicators of different types of pathogenetic mechanisms in certain forms of GN.

Adult↗
PubMed1986

Monoclonal anti-human C4b antibodies: stabilization and inhibition of the classical-pathway C3 convertase.

Two IgG mouse monoclonal antibodies (MAbs), Abs 242 and 463, were prepared by fusion of spleen cells from mice immunized with human C4b with a myeloma cell line, P3/ X 63-Ag 8.653. They were assessed for their effect on the activation and stability of the cell-bound classical-pathway C3 convertase, EAC14b2a and on the binding of C2 and C4bp to EC4b. Ab 242 recognized a conformational neoantigen which appeared upon activation of C4 with C-1s and disappeared after chain separation of C4b, while Ab 463 recognized a linear epitope in the beta-chain of C4b. Ab 242 was found to be a C4bp-like MAb: it accelerates the decay-dissociation of C3 convertase and interferes with the binding of C2 to C4b. It also interfered with the binding of C4bp to C4b. These results suggest that Ab 242 recognizes an epitope which is closely related to the C2- and C4bp-binding sites in C4b. Ab 463, on the other hand, was found to be a nephritic factor like MAb: it prolongs the half-life of C3 convertase from 8 to 30 min at 37 degrees C.

Animals↗
PubMed1976

Nephritic factor: Description of a new quantitative assay and findings in glomerulonephritis.

A sensitive quantitative test for nephritic factor (NF) in human serum is reported. The test is based on the capacity of NF to initiate fluid phase consumption of the third complement (C) component in the presence of magnesium ions (Mg++) and of factors of the alternative pathway of C activation. These factors as well as C3 and C5 were supplied by the incorporation of normal human serum (NHS) into the assay mixture. In order to prevent C3 (and C5) consumption via the Ca++- and Mg++-dependent classical pathway, the test was performed in the presence of the chelating agent Mg-ethylene bis (oxyethylene-nitrilo) tetraacetic acid (Mg EGTA) which interacts preferentially with Ca++. The Mg EGTA concentration was found to be critical, a final concentration of 5 mM in the assay mixture being required for optimal results. By its heat stability (54 degrees to 56 degrees C, 30 min), NF could be distinguished from other, heat-labile NF-like factors. The NF test was applied to five categories of patients with glomerulonephritis (GN). Heat-stable NF activity was found in seven of 17 sera in the membranoproliferative glomerulonephritis (MPGN) group. Two of the 12 acute poststreptococcal GN sera had NF-like activity which disappeared upon heating. Serum C3 and proactivator (PA) concentrations varied widely in all groups but a clear positive relationship was found between the presence of NF and low serum C3 concentrations in MPGN. Renal immunofluorescence in MPGN indicated a lesser amount of lg deposited in glomeruli from patients with NF when compared to the NF-negative patients. Both groups had heavy C3 deposits. The availability of a sensitive, quantitative assay for NF may help to provide further insight into the various pathogenic mechanisms in different forms of MPGN.

Acute Disease↗
PubMed1990

Patterns of complement activation in idiopathic membranoproliferative glomerulonephritis, types I, II, and III.

Complement profiles on 22 hypocomplementemic patients with membranoproliferative glomerulonephritis (MPGN) type I, on 11 with MPGN II, and on 16 with MPGN III, gave evidence that the nephritic factor of the amplification loop (NFa) is responsible for the hypocomplementemia in MPGN II and the nephritic factor of the terminal pathway (NFt) for the hypocomplementemia in MPGN III. In contrast, in MPGN I, there was evidence for three complement-activating modalities, NFa, NFt, and immune complexes. As a result, four different patterns of complement activation were seen. NFa, found in MPGN II, produces a complement profile characterized mainly by C3 depression. In addition, four of seven (57%) severely hypocomplementemic MPGN II patients (C3 less than 30 mg/dL) had slightly depressed levels of factor B, and one of seven (14%) of properdin, but in all the C5 concentration was normal. In contrast, all eight severely hypocomplementemic patients with MPGN II had depressed C5 and properdin levels, and six of eight (75%) depressed levels of C6, C7, and/or C9. Of eight MPGN III patients with moderate hypocomplementemia, 50% had depressed C5 and properdin levels and the remainder, depressed C3 only. This spectrum of profiles is most likely produced by varying concentrations of NFt. In MPGN I, nine of 23 (39%) had a profile indicating only classical pathway activation; seven of 23 (39%), a pattern compatible with NFt alone; four of 23 (9%), evidence for both classical pathway activation and NFt; and three of 23 (13%), a pattern compatible with NFa. The unique multifactorial origin of the hypocomplementemia in MPGN I, often giving evidence of classical pathway activation, together with previously reported differences in glomerular morphology and clinical features at onset, makes it distinct from MPGN III. Depressed C8 levels were found to some extent in all hypocomplementemic states. The levels were uncommonly depressed in patients with NFa, most markedly depressed with NFt, and moderately reduced with classical pathway activation. The cause is not known. Diagnostically, profiles showing classical pathway activation and low levels of C6, C7, and/or C9 are specific for MPGN I. Those showing only classical activation are likewise diagnostic of MPGN I if systemic lupus erythematosus (SLE) and chronic bacteremia are ruled out.

Complement Activation↗
PubMed1984

Physiologic inactivation of fluid phase C3b: isolation and structural analysis of C3c, C3d,g (alpha 2D), and C3g.

The fragments that result from the inactivation of C3b have not been completely characterized. Initial inactivation is catalyzed by the protease factor I, which, in the presence of its cofactor (factor H), cleaves two peptide bonds in the alpha'-chain of C3b. This results in the release of a small peptide (C3f, Mr 3000) from iC3b, which consists of the C3 beta chain covalently bonded to two alpha'-chain-derived peptides (Mr 68,000 and Mr 43,000). Surface-bound iC3b is cleaved at a third site by factor I to produce C3c and C3d,g (or alpha 2D). The factor I cofactor for this cleavage is the C3b receptor that is present on erythrocyte and leukocyte membranes. This report describes the isolation and initial structural characterization of C3c and C3d,g generated in whole blood after complement activation with cobra venom factor. These fragments were compared with the C3 fragments isolated from the serum and plasma of a patient with complement activation in vivo. The fragments were isolated with two solid phase monoclonal antibodies, one of which recognizes a determinant on C3g (clone 9) and one of which recognizes a determinant on C3c (clone 4). C3c isolated from normal blood showed three polypeptides that had apparent m.w. of 75,000, 43,000, and 27,000. The C3d,g consisted of a single polypeptide chain with a m.w. of 40,000. Amino terminal sequence analysis showed that the Mr 27,000 peptide from C3c is derived from the amino terminal portion of the alpha'-chain of C3b, whereas the Mr 43,000 peptide is derived from the carboxy terminus of the same chain. Amino terminal sequence analysis showed also that C3g is derived from the amino terminus of C3d,g. The C3 fragments isolated from a patient with partial lipodystrophy, nephritic factor activity, low serum C3 levels, and circulating C3 cleavage products showed a more complicated pattern on SDS-PAGE. The fragment isolated with clone 9 had an apparent m.w. of 40,000, identical to C3d,g generated in vitro, and it had the same amino terminal sequence as C3d,g generated in vitro. The eluate from insolubilized clone 4, however, showed prominent bands with Mr of 75,000, 56,000, 43,000, and 27,000, together with a triple-banded pattern at 68,000 and a minor band at 80,000. This eluate thus appears to contain C3c, and iC3b or an iC3b-like product. The origin of the Mr 56,000 and Mr 80,000 peptides have not yet been determined. These studies, with previous data, definitively order the C3c and C3d,g peptides in the alpha-chain of C3.(ABSTRACT TRUNCATED AT 400 WORDS)

Amino Acid Sequence↗