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2018 ; 3
(2
): 302-313
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Complement Activation in Patients With Diabetic Nephropathy
#MMPMID29725633
Bus P
; Chua JS
; Klessens CQF
; Zandbergen M
; Wolterbeek R
; van Kooten C
; Trouw LA
; Bruijn JA
; Baelde HJ
Kidney Int Rep
2018[Mar]; 3
(2
): 302-313
PMID29725633
show ga
INTRODUCTION: Complement activation plays a role in various organs in patients
with diabetes. However, in diabetic nephropathy (DN), the role of complement
activation is poorly understood. We examined the prevalence and clinical
significance of complement deposits in the renal tissue of cases with type 1 and
type 2 diabetes with and without DN. METHODS: We measured the prevalence of
glomerular C4d, C1q, mannose-binding lectin (MBL), and C5b-9 deposits in 101
autopsied diabetic cases with DN, 59 autopsied diabetic cases without DN, and 41
autopsied cases without diabetes or kidney disease. The presence of complement
deposits was scored by researchers who were blinded with respect to the clinical
and histological data. RESULTS: C4d deposits were more prevalent in cases with DN
than in cases without DN in both the glomeruli (46% vs. 26%) and the arterioles
(28% vs. 12%). C1q deposits were also increased in the glomerular hili (77% vs.
55%) and arterioles (33% vs.14%), and were correlated with DN (P < 0.01). MBL
deposits were only rarely observed. C5b-9 deposits were more prevalent in the
cases with diabetes mellitus (DM) than in the cases without DM (69% vs. 32%; P <
0.001). Finally, glomerular C4d and C5b-9 deposits were correlated with the
severity of DN (? = 0.341 and 0.259, respectively; P < 0.001). CONCLUSION:
Complement activation is correlated with both the presence and severity of DN,
suggesting that the complement system is involved in the development of renal
pathology in patients with diabetes and is a promising target for inhibiting
and/or preventing DN in these patients.