Nephrology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Japan.
Department of Renal Replacement Therapy, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Japan.
BMC Nephrol. 2023 Feb 2;24(1):26. doi: 10.1186/s12882-022-03022-z.
During the last few decades, pathogenic mechanisms associated with uncontrolled activation of the complement (C) system and development of anti-C agents have been closely investigated in the field of nephrology. The usefulness of some C products such as C5a and sC5b-9 for diagnostic and prognostic purposes remains controversial. On the other hand, decreased renal function is being observed in many patients with or without nephritis as a background factor in progressively aging societies. We therefore investigated whether renal function influenced the evaluation of various complement components and activation products.
To investigate the influence of renal function on evaluations of C3, C4, CH50, Ba, C5a and sC5b-9, 40 patients were retrospectively chosen from among 844 patients without active glomerulonephritis from 2009 to 2016. We measured plasma and serum levels of C3, C4, CH50, Ba, C5a and sC5b-9 using enzyme-linked immunosorbent assays and compared the findings with inulin clearance (Cin) as a marker of preserved renal function.
Both plasma and serum levels of Ba correlated significantly with Cin, but other values did not. Compared with patients with Cin ≥ 60 or ≥ 30 mL/min/1.73 m, plasma and serum levels of Ba were increased in patients with Cin decreased to < 60 or < 30 mL/min/1.73 m, but levels of C5a and sC5b-9 were not.
The influence of renal function might need to be considered when evaluating Ba, but not C5a and sC5b-9, in plasma and serum samples from chronic kidney disease patients.
在过去的几十年中,肾脏病学领域一直在深入研究与补体(C)系统失控激活和抗 C 抗体产生相关的发病机制。一些 C 产物(如 C5a 和 sC5b-9)在诊断和预后方面的用途仍存在争议。另一方面,肾功能下降在许多患有或不患有肾炎的患者中作为老龄化社会的背景因素而被观察到。因此,我们研究了肾功能是否会影响对各种补体成分和激活产物的评估。
为了研究肾功能对 C3、C4、CH50、Ba、C5a 和 sC5b-9 评估的影响,我们从 2009 年至 2016 年的 844 例无活动性肾小球肾炎患者中回顾性选择了 40 例患者。我们使用酶联免疫吸附试验测量了血浆和血清中 C3、C4、CH50、Ba、C5a 和 sC5b-9 的水平,并将结果与作为保留肾功能标志物的菊粉清除率(Cin)进行比较。
Ba 的血浆和血清水平均与 Cin 显著相关,但其他值则没有。与 Cin≥60 或≥30 mL/min/1.73 m 的患者相比,Cin 降低至<60 或<30 mL/min/1.73 m 的患者的血浆和血清中 Ba 的水平升高,但 C5a 和 sC5b-9 的水平则没有升高。
在评估慢性肾脏病患者的血浆和血清样本中的 Ba 时,可能需要考虑肾功能的影响,但 C5a 和 sC5b-9 则不需要。