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Review
. 2019 Aug;34(8):1311-1323.
doi: 10.1007/s00467-018-3989-0. Epub 2018 Jun 9.

Autoimmune abnormalities of the alternative complement pathway in membranoproliferative glomerulonephritis and C3 glomerulopathy

Marina Noris  1 , Roberta Donadelli  2 , Giuseppe Remuzzi  2   3   4
Affiliations
Review

Autoimmune abnormalities of the alternative complement pathway in membranoproliferative glomerulonephritis and C3 glomerulopathy

Marina Noris et al. Pediatr Nephrol. 2019 Aug.

Abstract

Membranoproliferative glomerulonephritis (MPGN) is a rare chronic kidney disease associated with complement activation. Recent immunofluorescence-based classification distinguishes between immune complex (IC)-mediated MPGN, with glomerular IgG and C3 deposits, and C3 glomerulopathies (C3G), with predominant C3 deposits. Genetic and autoimmune abnormalities causing hyperactivation of the complement alternative pathway have been found as frequently in patients with immune complex-associated MPGN (IC-MPGN) as in those with C3G. In the last decade, there have been great advances in research into the autoimmune causes of IC-MPGN and C3G. The complement-activating autoantibodies called C3-nephritic factors (C3NeFs), which are present in 40-80% of patients, form a heterogeneous group of autoantibodies that stabilise the C3 convertase or the C5 convertase of the alternative pathway or both. A few patients, mainly with IC-MPGN, carry autoantibodies directed against the two components of the alternative pathway C3 convertase, factors B and C3b. Finally, autoantibodies against factor H, the main regulator of the alternative pathway, have been reported in a small proportion of patients with IC-MPGN or C3G. The identification of distinct pathogenetic patterns leading to kidney injury and of targets in the complement cascade may pave the way for tailored therapies for IC-MPGN and C3G, with specific complement inhibitors in the development pipeline.

Keywords: Alternative pathway; Autoantibodies; C3 glomerulopathy; Complement; Membranoproliferative glomerulonephritis; Nephritic factor.

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References

    1. Clin Nephrol. 1982 Nov;18(5):240-6 - PubMed
    1. Mol Immunol. 2016 Mar;71:131-142 - PubMed
    1. BMC Biol. 2015 Nov 09;13:93 - PubMed
    1. J Am Soc Nephrol. 2005 May;16(5):1392-403 - PubMed
    1. Clin Immunol Immunopathol. 1978 Aug;10(4):477-92 - PubMed

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