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2016 ; 12
(7
): 383-401
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Complement in disease: a defence system turning offensive
#MMPMID27211870
Ricklin D
; Reis ES
; Lambris JD
Nat Rev Nephrol
2016[Jul]; 12
(7
): 383-401
PMID27211870
show ga
Although the complement system is primarily perceived as a host defence system, a
more versatile, yet potentially more harmful side of this innate immune pathway
as an inflammatory mediator also exists. The activities that define the ability
of the complement system to control microbial threats and eliminate cellular
debris - such as sensing molecular danger patterns, generating immediate
effectors, and extensively coordinating with other defence pathways - can quickly
turn complement from a defence system to an aggressor that drives immune and
inflammatory diseases. These host-offensive actions become more pronounced with
age and are exacerbated by a variety of genetic factors and autoimmune responses.
Complement can also be activated inappropriately, for example in response to
biomaterials or transplants. A wealth of research over the past two decades has
led to an increasingly finely tuned understanding of complement activation,
identified tipping points between physiological and pathological behaviour, and
revealed avenues for therapeutic intervention. This Review summarizes our current
view of the key activating, regulatory, and effector mechanisms of the complement
system, highlighting important crosstalk connections, and, with an emphasis on
kidney disease and transplantation, discusses the involvement of complement in
clinical conditions and promising therapeutic approaches.