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补体系统紊乱与溶血尿毒综合征。

Complement disorders and hemolytic uremic syndrome.

机构信息

Department of Pediatrics, University of Texas, Southwestern Medical Center, Dallas, Texas 75390-9063, USA.

出版信息

Curr Opin Pediatr. 2013 Apr;25(2):209-15. doi: 10.1097/MOP.0b013e32835df48a.

DOI:10.1097/MOP.0b013e32835df48a
PMID:23399570
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3758882/
Abstract

PURPOSE OF REVIEW

Complement mediated hemolytic uremic syndrome (aHUS) accounts for a significant proportion of non-shiga toxin HUS. The purpose of this review is to outline the pathophysiology, clinical features and therapeutic options for aHUS.

RECENT FINDINGS

In the last decade, strides have been made in identifying several new disease-causing mutations in complement-regulating proteins.

SUMMARY

Complement mediated HUS (aHUS) has a worse prognosis compared with shiga toxin mediated HUS, often resulting in end stage renal disease. Early identification of aHUS is crucial so that plasma therapy can be initiated. After renal transplantation, there is very high risk of disease recurrence and graft loss. Eculizumab and combined liver-kidney transplantation offer promise for improved prognosis.

摘要

目的综述

补体介导的溶血尿毒症综合征(aHUS)占非志贺毒素 HUS 的很大比例。本文旨在概述 aHUS 的病理生理学、临床特征和治疗选择。

最新发现

在过去十年中,人们在鉴定补体调节蛋白中的几种新致病突变方面取得了进展。

总结

与志贺毒素介导的 HUS 相比,补体介导的 HUS(aHUS)预后更差,常导致终末期肾病。早期识别 aHUS 至关重要,以便可以开始血浆治疗。肾移植后,疾病复发和移植物丢失的风险非常高。依库珠单抗和肝肾联合移植为改善预后提供了希望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/673a/3758882/b5e867adbeb9/nihms502907f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/673a/3758882/b5e867adbeb9/nihms502907f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/673a/3758882/b5e867adbeb9/nihms502907f1.jpg

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Atypical hemolytic uremic syndrome in children: complement mutations and clinical characteristics.儿童非典型溶血尿毒综合征:补体突变与临床特征。
Pediatr Nephrol. 2012 Aug;27(8):1283-91. doi: 10.1007/s00467-012-2131-y. Epub 2012 Mar 13.
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A prevalent C3 mutation in aHUS patients causes a direct C3 convertase gain of function.在 aHUS 患者中普遍存在的 C3 突变导致直接 C3 转化酶获得功能。
补体系统在 COVID-19 和其他呼吸道病毒疾病中的新作用。
Cell Mol Life Sci. 2024 Feb 18;81(1):94. doi: 10.1007/s00018-024-05157-8.
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Iron accumulation drives fibrosis, senescence and the senescence-associated secretory phenotype.铁积累驱动纤维化、衰老和衰老相关分泌表型。
Nat Metab. 2023 Dec;5(12):2111-2130. doi: 10.1038/s42255-023-00928-2. Epub 2023 Dec 14.
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