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2016 ; 18
(1
): 267
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Analysis of complement biomarkers in systemic sclerosis indicates a distinct
pattern in scleroderma renal crisis
#MMPMID27863511
Okrój M
; Johansson M
; Saxne T
; Blom AM
; Hesselstrand R
Arthritis Res Ther
2016[Nov]; 18
(1
): 267
PMID27863511
show ga
BACKGROUND: The complement system has been implicated in pathogenesis of systemic
sclerosis (SSc). The goal of the present study was to evaluate improved
complement biomarkers in SSc. METHODS: The presence of C4d, reflecting activation
of the classical/lectin pathways, C3bBbP corresponding to activation of the
alternative pathway, and soluble terminal complement complexes (all complement
pathways), was measured in plasma samples by enzyme-linked immunosorbent assay
and correlated to clinical parameters. The study included 81 patients with
limited cutaneous SSc and 41 with diffuse cutaneous SSc, as well as 47 matched
healthy controls and 81 patients with rheumatoid arthritis, 22 with psoriatic
arthritis and 20 with ankylosing spondylitis. Skin and kidney biopsies of
selected patients were stained to detect deposited C3b as a marker of local
complement activation. RESULTS: Biomarkers of activation of all complement
pathways were increased in SSc compared with healthy controls and were similar to
those in other rheumatic diseases. When patients with SSc were divided into
subgroups, a distinct pattern of complement markers was observed in individuals
with scleroderma renal crisis (SRC). By functional assay, we confirmed a
significant decrease in complement haemolytic activity in SRC vs. non-SRC
patients, indicating complement consumption. Further, we detected glomerular
deposits of C3b in some patients with SRC. CONCLUSIONS: The data indicate that
complement activation is an important feature of SRC.