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Pathogenesis and significance of glomerular C4d deposition in lupus nephritis: activation of classical and lectin pathways

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Author(s)
Min-Kyung KimYoung-In MaengSun-Jae LeeIn Hee LeeJisuk BaeYu-Na KangByung-Tae ParkKwan-Kyu Park
Keimyung Author(s)
Kang, Yu Na
Department
Dept. of Pathology (병리학)
Journal Title
International Journal of Clinical and Experimental Pathology
Issued Date
2013
Volume
6
Issue
10
Abstract
Immune complex-mediated complement activation through the classic pathway plays a key role in the pathogenesis of lupus nephritis (LN). C4d deposition in renal tissue reflects the prognosis of systemic lupus erythematosus (SLE). The aim of the current study is to investigate the pathogenesis and clinicopathologic significance of glomerular C4d deposition in LN. We retrospectively analyzed clinical and histopathological data of 20 SLE patients with renal biopsy-proven LN and 10 non-SLE renal biopsy samples as control. LN biopsies showed varying degrees of glomerular C4d staining associated with immune complex deposits, IgG (p = 0.015), C1q (p = 0.032) and C3 (p = 0.049). 7 LN biopsies had all of C4d, C1q and C3 deposits in their glomeruli, indicative of the activation of the classical pathway, whereas 2 LN biopsies had C4d and C3 deposits without accompanying C1q deposits, indicating the activation of the lectin pathway. Glomerular C4d deposition was correlated with the LN subtype (p < 0.001). In particular, a diffusely intense and coarsely granular pattern of C4d deposition in all glomeruli was detected in class V membranous LN. However, glomerular C4d deposition was correlated with neither disease activity of SLE nor histological activity and chronicity of LN. In conclusion, the activation of the lectin pathway as well as the classical pathway seems to play a crucial role in the pathogenesis of LN. Glomerular C4d staining could be helpful for diagnosing class V membranous LN, although glomerular C4d deposition does not reflect SLE disease activity and histological activity and chronicity.
Keywords: Lupus nephritis, C4d, classical pathway, lectin pathway, disease activity
Keimyung Author(s)(Kor)
강유나
Publisher
School of Medicine
Citation
Min-Kyung Kim et al. (2013). Pathogenesis and significance of glomerular C4d
deposition in lupus nephritis: activation
of classical and lectin pathways. International Journal of Clinical and Experimental Pathology, 6(10), 2157–2167.
Type
Article
ISSN
1936-2625
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35899
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
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