The Development of Atypical Hemolytic Uremic Syndrome Depends on Complement C5

Gene variants in the alternative pathway of the complement system strongly associate with atypical hemolytic uremic syndrome (aHUS), presumably by predisposing to increased complement activation within the kidney. Complement factor H (CFH) is the major regulator of complement activation through the...

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Veröffentlicht in:Journal of the American Society of Nephrology 2011, Vol.22 (1), p.137-145
Hauptverfasser: GOICOECHEA DE JORGE, Elena, MACOR, Paolo, PAIXAO-CAVALCANTE, Danielle, ROSE, Kirsten L, TEDESCO, Franco, TERENCE COOK, H, BOTTO, Marina, PICKERING, Matthew C
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container_issue 1
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container_title Journal of the American Society of Nephrology
container_volume 22
creator GOICOECHEA DE JORGE, Elena
MACOR, Paolo
PAIXAO-CAVALCANTE, Danielle
ROSE, Kirsten L
TEDESCO, Franco
TERENCE COOK, H
BOTTO, Marina
PICKERING, Matthew C
description Gene variants in the alternative pathway of the complement system strongly associate with atypical hemolytic uremic syndrome (aHUS), presumably by predisposing to increased complement activation within the kidney. Complement factor H (CFH) is the major regulator of complement activation through the alternative pathway. Factor H-deficient mice transgenically expressing a mutant CFH protein (Cfh(-/-).FHΔ16-20) that functionally mimics the CFH mutations reported in aHUS patients spontaneously develop thrombotic microangiopathy. To investigate the role of complement C5 activation in this aHUS model, we generated C5-deficient Cfh(-/-).FHΔ16-20 mice. Both C5-sufficient and C5-deficient Cfh(-/-).FHΔ16-20 mice had abnormal C3 deposition within the kidney, but spontaneous aHUS did not develop in any of the C5-deficient mice. Furthermore, although Cfh(-/-).FHΔ16-20 animals demonstrated marked hypersensitivity to experimentally triggered renal injury, animals with concomitant C5 deficiency did not. These data demonstrate a critical role for C5 activation in both spontaneous aHUS and experimentally triggered renal injury in animals with defective complement factor H function. This study provides a rationale to investigate therapeutic inhibition of C5 in human aHUS.
doi_str_mv 10.1681/asn.2010050451
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Complement factor H (CFH) is the major regulator of complement activation through the alternative pathway. Factor H-deficient mice transgenically expressing a mutant CFH protein (Cfh(-/-).FHΔ16-20) that functionally mimics the CFH mutations reported in aHUS patients spontaneously develop thrombotic microangiopathy. To investigate the role of complement C5 activation in this aHUS model, we generated C5-deficient Cfh(-/-).FHΔ16-20 mice. Both C5-sufficient and C5-deficient Cfh(-/-).FHΔ16-20 mice had abnormal C3 deposition within the kidney, but spontaneous aHUS did not develop in any of the C5-deficient mice. Furthermore, although Cfh(-/-).FHΔ16-20 animals demonstrated marked hypersensitivity to experimentally triggered renal injury, animals with concomitant C5 deficiency did not. These data demonstrate a critical role for C5 activation in both spontaneous aHUS and experimentally triggered renal injury in animals with defective complement factor H function. This study provides a rationale to investigate therapeutic inhibition of C5 in human aHUS.</description><identifier>ISSN: 1046-6673</identifier><identifier>EISSN: 1533-3450</identifier><identifier>DOI: 10.1681/asn.2010050451</identifier><identifier>PMID: 21148255</identifier><identifier>CODEN: JASNEU</identifier><language>eng</language><publisher>Washington, DC: American Society of Nephrology</publisher><subject>Animals ; Atypical Hemolytic Uremic Syndrome ; Basic Research ; Biological and medical sciences ; Complement C3 - metabolism ; Complement C5 - deficiency ; Complement C5 - genetics ; Complement C5 - physiology ; Complement C9 - metabolism ; Complement Factor H - deficiency ; Complement Factor H - genetics ; Complement Factor H - physiology ; Disease Models, Animal ; Glomerular Mesangium - metabolism ; Hematologic and hematopoietic diseases ; Hemolytic-Uremic Syndrome - physiopathology ; Medical sciences ; Mice ; Mice, Inbred C57BL ; Mice, Inbred CBA ; Mice, Knockout ; Nephrology. 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This study provides a rationale to investigate therapeutic inhibition of C5 in human aHUS.</description><subject>Animals</subject><subject>Atypical Hemolytic Uremic Syndrome</subject><subject>Basic Research</subject><subject>Biological and medical sciences</subject><subject>Complement C3 - metabolism</subject><subject>Complement C5 - deficiency</subject><subject>Complement C5 - genetics</subject><subject>Complement C5 - physiology</subject><subject>Complement C9 - metabolism</subject><subject>Complement Factor H - deficiency</subject><subject>Complement Factor H - genetics</subject><subject>Complement Factor H - physiology</subject><subject>Disease Models, Animal</subject><subject>Glomerular Mesangium - metabolism</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hemolytic-Uremic Syndrome - physiopathology</subject><subject>Medical sciences</subject><subject>Mice</subject><subject>Mice, Inbred C57BL</subject><subject>Mice, Inbred CBA</subject><subject>Mice, Knockout</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Platelet diseases and coagulopathies</subject><subject>Renal failure</subject><issn>1046-6673</issn><issn>1533-3450</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc1v1DAQxS0Eoh9w5YhyQZyyjL8S54K02lKKVJVD27M1a49pUBIHO1tp_3tcurRwmpHm9948zTD2jsOKN4Z_wjytBHAADUrzF-yYaylrqTS8LD2opm6aVh6xk5x_AnAt2vY1OxKcKyO0PmZXN3dUndE9DXEeaVqqGKr1sp97h0N1QWMc9kvvqttEYynX-8mnOD4oZpp8ruJUbeI4D_RHu9Fv2KuAQ6a3h3rKbs-_3Gwu6svvX79t1pe1U0YvdReE8x6BtxINBI9cGNw6dOCxc4GLVilC3Qrvt6bzqNBthSDCYEQjIchT9vnRd95tR_KubE842Dn1I6a9jdjb_ydTf2d_xHsrgStQohh8PBik-GtHebFjnx0NA04Ud9kaITrgBrpCrh5Jl2LOicLTFg724Qd2fX1ln39QBO__zfaE_z16AT4cAMzlzCHh5Pr8zMm2RDSN_A1sBJDd</recordid><startdate>2011</startdate><enddate>2011</enddate><creator>GOICOECHEA DE JORGE, Elena</creator><creator>MACOR, Paolo</creator><creator>PAIXAO-CAVALCANTE, Danielle</creator><creator>ROSE, Kirsten L</creator><creator>TEDESCO, Franco</creator><creator>TERENCE COOK, H</creator><creator>BOTTO, Marina</creator><creator>PICKERING, Matthew C</creator><general>American Society of Nephrology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2011</creationdate><title>The Development of Atypical Hemolytic Uremic Syndrome Depends on Complement C5</title><author>GOICOECHEA DE JORGE, Elena ; MACOR, Paolo ; PAIXAO-CAVALCANTE, Danielle ; ROSE, Kirsten L ; TEDESCO, Franco ; TERENCE COOK, H ; BOTTO, Marina ; PICKERING, Matthew C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-9f2cdda0173a80fda128abcac0da9cf12744ea572ddb89da4acb22eeaf82630f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Animals</topic><topic>Atypical Hemolytic Uremic Syndrome</topic><topic>Basic Research</topic><topic>Biological and medical sciences</topic><topic>Complement C3 - metabolism</topic><topic>Complement C5 - deficiency</topic><topic>Complement C5 - genetics</topic><topic>Complement C5 - physiology</topic><topic>Complement C9 - metabolism</topic><topic>Complement Factor H - deficiency</topic><topic>Complement Factor H - genetics</topic><topic>Complement Factor H - physiology</topic><topic>Disease Models, Animal</topic><topic>Glomerular Mesangium - metabolism</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hemolytic-Uremic Syndrome - physiopathology</topic><topic>Medical sciences</topic><topic>Mice</topic><topic>Mice, Inbred C57BL</topic><topic>Mice, Inbred CBA</topic><topic>Mice, Knockout</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Platelet diseases and coagulopathies</topic><topic>Renal failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GOICOECHEA DE JORGE, Elena</creatorcontrib><creatorcontrib>MACOR, Paolo</creatorcontrib><creatorcontrib>PAIXAO-CAVALCANTE, Danielle</creatorcontrib><creatorcontrib>ROSE, Kirsten L</creatorcontrib><creatorcontrib>TEDESCO, Franco</creatorcontrib><creatorcontrib>TERENCE COOK, H</creatorcontrib><creatorcontrib>BOTTO, Marina</creatorcontrib><creatorcontrib>PICKERING, Matthew C</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GOICOECHEA DE JORGE, Elena</au><au>MACOR, Paolo</au><au>PAIXAO-CAVALCANTE, Danielle</au><au>ROSE, Kirsten L</au><au>TEDESCO, Franco</au><au>TERENCE COOK, H</au><au>BOTTO, Marina</au><au>PICKERING, Matthew C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Development of Atypical Hemolytic Uremic Syndrome Depends on Complement C5</atitle><jtitle>Journal of the American Society of Nephrology</jtitle><addtitle>J Am Soc Nephrol</addtitle><date>2011</date><risdate>2011</risdate><volume>22</volume><issue>1</issue><spage>137</spage><epage>145</epage><pages>137-145</pages><issn>1046-6673</issn><eissn>1533-3450</eissn><coden>JASNEU</coden><abstract>Gene variants in the alternative pathway of the complement system strongly associate with atypical hemolytic uremic syndrome (aHUS), presumably by predisposing to increased complement activation within the kidney. Complement factor H (CFH) is the major regulator of complement activation through the alternative pathway. Factor H-deficient mice transgenically expressing a mutant CFH protein (Cfh(-/-).FHΔ16-20) that functionally mimics the CFH mutations reported in aHUS patients spontaneously develop thrombotic microangiopathy. To investigate the role of complement C5 activation in this aHUS model, we generated C5-deficient Cfh(-/-).FHΔ16-20 mice. Both C5-sufficient and C5-deficient Cfh(-/-).FHΔ16-20 mice had abnormal C3 deposition within the kidney, but spontaneous aHUS did not develop in any of the C5-deficient mice. Furthermore, although Cfh(-/-).FHΔ16-20 animals demonstrated marked hypersensitivity to experimentally triggered renal injury, animals with concomitant C5 deficiency did not. These data demonstrate a critical role for C5 activation in both spontaneous aHUS and experimentally triggered renal injury in animals with defective complement factor H function. This study provides a rationale to investigate therapeutic inhibition of C5 in human aHUS.</abstract><cop>Washington, DC</cop><pub>American Society of Nephrology</pub><pmid>21148255</pmid><doi>10.1681/asn.2010050451</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Animals
Atypical Hemolytic Uremic Syndrome
Basic Research
Biological and medical sciences
Complement C3 - metabolism
Complement C5 - deficiency
Complement C5 - genetics
Complement C5 - physiology
Complement C9 - metabolism
Complement Factor H - deficiency
Complement Factor H - genetics
Complement Factor H - physiology
Disease Models, Animal
Glomerular Mesangium - metabolism
Hematologic and hematopoietic diseases
Hemolytic-Uremic Syndrome - physiopathology
Medical sciences
Mice
Mice, Inbred C57BL
Mice, Inbred CBA
Mice, Knockout
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Platelet diseases and coagulopathies
Renal failure
title The Development of Atypical Hemolytic Uremic Syndrome Depends on Complement C5
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