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2018 ; 9
(ä): 848
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High Complement Factor H-Related (FHR)-3 Levels Are Associated With the Atypical
Hemolytic-Uremic Syndrome-Risk Allele CFHR3*B
#MMPMID29740447
Pouw RB
; Gómez Delgado I
; López Lera A
; Rodríguez de Córdoba S
; Wouters D
; Kuijpers TW
; Sánchez-Corral P
Front Immunol
2018[]; 9
(ä): 848
PMID29740447
show ga
Dysregulation of the complement alternative pathway (AP) is a major pathogenic
mechanism in atypical hemolytic-uremic syndrome (aHUS). Genetic or acquired
defects in factor H (FH), the main AP regulator, are major aHUS drivers that
associate with a poor prognosis. FH activity has been suggested to be
downregulated by homologous FH-related (FHR) proteins, including FHR-3 and FHR-1.
Hence, their relative levels in plasma could be disease-relevant. The genes
coding for FH, FHR-3, and FHR-1 (CFH, CFHR3, and CFHR1, respectively) are
polymorphic and located adjacent to each other on human chromosome 1q31.3. We
have previously shown that haplotype CFH(H3)-CFHR3*B-CFHR1*B associates with aHUS
and reduced FH levels. In this study, we used a specific enzyme-linked
immunosorbent assay to quantify FHR-3 in plasma samples from controls and
patients with aHUS genotyped for the three known CFHR3 alleles (CFHR3*A, CFHR3*B,
and CFHR3*Del). In the 218 patients carrying at least one copy of CFHR3,
significant differences between CFHR3 genotype groups were found, with
CFHR3*A/Del patients having the lowest FHR-3 concentration (0.684-1.032?µg/mL),
CFHR3*B/Del and CFHR3*A/A patients presenting intermediate levels
(1.437-2.201?µg/mL), and CFHR3*A/B and CFHR3*B/B patients showing the highest
concentration (2.330-4.056?µg/mL) (p?0.001). These data indicate that CFHR3*A
is a low-expression allele, whereas CFHR3*B, associated with increased risk of
aHUS, is a high-expression allele. Our study reveals that the aHUS-risk haplotype
CFH(H3)-CFHR3*B-CFHR1*B generates twofold more FHR-3 than the non-risk
CFH(H1)-CFHR3*A-CFHR1*A haplotype. In addition, FHR-3 levels were higher in
patients with aHUS than in control individuals with the same CFHR3 genotype.
These data suggest that increased plasma levels of FHR-3, altering the balance
between FH and FHR-3, likely impact the FH regulatory functions and contribute to
the development of aHUS.