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Complement activation products in the circulation and urine of primary membranous nephropathy

BMC Nephrology Aug 15, 2019

Zhang MF, Huang J, Zhang YM, et al. - Among 134 patients with biopsy-proven primary membranous nephropathy (pMN), researchers focused on the alterations of complement activation products in circulation and urine, given a substantial role of complement activation in the pathogenesis of pMN. Using enzyme-linked immunosorbent assay, they measured the circulating and urinary levels of C1q, mannose binding lectin, C4d, Bb, properdin, C3a, C5a, and soluble C5b-9 in the participants. A remarkable rise in the circulating and urinary levels of C3a was noted, which was much higher than the increased levels of C5a. A positive correlation of urinary C5a with anti-PLA2R (M-type phospholipase A2 receptor) antibody levels and urinary protein was found. In pMN, remarkably increased complement activation products were detected, which could be used as sensitive biomarkers of disease activity. In the presence of anti-PLA2R antibodies and in the absence of antibody, the complement may be activated via lectin pathway and alternative pathway, respectively.
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