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Objective Complement plays an important role in the pathogenesis of myasthenia gravis.The formation of membrane attck complex and the damage of neuromuscular junction are inseparable from the activation of complement.Then to investigate the influencing factors of serum complement C3,C4 in children with myasthenia gravis and investigate the degree of influence of related factors.Methods One hundred sixty seven cases of hospitalized or outpatient myasthenia gravis children from the Department of Neurology in Hunan Children's Hospital were collected,including 33 cases of general MG,134 cases of ocular MG,and 36 cases of normal children as control group.The concentrations of serum C3,C4,IgG,IgM,IgA,IgE were detected by immune compare turbid.The influencing factors of complement C3,C4 were investigated and compared.Results The serum C3 levels were 1.07 ± 0.22 g/L,and the serum C4 levels were(0.17 ± 0.05)g/L in the general MG.The serum C3 levels were (1.01 ± 0.20)g/L,the serum C4 levels were(0.20 ± 0.08)g/L in the ocular MG.There were(1.36 ± 0.28) g/L for C3 levels,(0.25 ± 0.11) g/L for C4 levels in the control group.Compared with the control group,there were significant difference in C3 and C4 between the general MG and ocular MG(P ＜0.01 or 0.05).The partial correlations coefficients of C3 and course of disease,IgG and C3,C3 and C4 were-0.162,0.135,0.446(P ＜0.01 or 0.05).The multiple linear regression equations were as followed:C4 =0.420 × C3,C3 =0.655 + 1.148 × C4 + 0.008 × body weight-.005 × course of disease.Using univaruate analysis,the effect factors of C4(F =18.151,P =0.000),body weight(F =6.420,P =0.003),course of disease (F =3.015,P =0.039),age × course of disease × body weight (F =2.997,P =0.042) to C3 were significant (P ＜ 0.05,or P ＜ 0.01).Conclusion The C3 levels are mainly affected by C4,body weight,duration and some interaction effects among several impact factors in children with MG.C4 is mainly affected by C3.
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Antibody-mediated rejection (AMR) is a rare event in liver transplantation compared to other solid organs such as the kidney and heart because of the different immunologic reactions in the liver and it ability to compensate for damage. Although it is not easy to define the histological features that help diagnosis because of its rarity, a few histologic features such as portal eosinophilia with eosinophilic endothelialitis have been reported as useful for diagnosis of acute AMR in presensitized patients. C4d staining is not a good indicator of AMR in liver grafts because of its low sensitivity and specificity. AMR is an emerging cause of chronic graft failure, especially in high risk patients having preformed or de novo donor specific alloantibodies (DSA). Some histologic parameters including interface hepatitis, lobular inflammation, portal collagenation, portal venopathy, and sinusoidal fibrosis, have been suggested as chronic AMR to predict graft fibrosis and survival in DSA positive patients. In conclusion, recent studies have resulted in the histological diagnostic criteria of AMR becoming more specific; however, confirmation of AMR still requires strong clinical evidence for alloantibodies.
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Humans , Collagen , Diagnosis , Eosinophilia , Eosinophils , Fibrosis , Graft Rejection , Heart , Hepatitis , Inflammation , Isoantibodies , Kidney , Liver Transplantation , Liver , Sensitivity and Specificity , Tissue Donors , TransplantsABSTRACT
Objective To explore the value of serum SC5b-9, anti-C1q antibody, C3 and C4 levels in the assessment of lupus activity. Methods The enzyme linked immunosorbent assay (ELISA) was used to measure SC5b-9 and anti-C1q antibody, rate nepheiometry was used to detect the serum level of C3 and C4 in sera of 62 SLE patients, 35 patients with other rheumatic diseases (including rheumatoid arthritis, ankylosing spondylitis, primary Sjogren' s syndrome, mixed connective tissue disease, dermatomyositis, polymyositis, systemic sclerosis and vasculitis) and 35 healthy controls. And the correlation between above-mentioned parameters and lupus clinical manifestations, disease activity and histological type of lupus nephritis were analyzed. Results In SLE patients, the levels of SC5b-9 and anti-C1q antibody were significantly higher than those in patients with other rheumatic diseases and healthy controls (P<0.05). The titers of SC5b-9 and anti-C1q antibody negatively correlated with C3 and C4 (P<0.05), and positively correlated with SLEDAI (P<0.05). The sensitivity and specificity of the combination of these three measurements for SLE was 95.37% and 98.46 respectively. SC5b-9 and anti-C1q antibody were associated with the presence of proliferative glomerulonephritis (P <0.05). Conclusion Taking the evaluation of all these three measurements simultaneously is valuable for the diagnosis of lupus flare. SC5b-9 and anti-C1q antibody may play major roles in the immunopathogenesis of lupus nephritis.
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Objective To detect the changes of serum complement 3(C_3) and C_4 in neonates with hypoxic-ischemic encephalopathy(HIE) and its effects on non-specific immunological function.Methods Sixty-seven neonates with HIE and 30 normal full-term infants were recruited in the study.According to characteristic of immunological function and severity of HIE,the neonates were divided into 1-3 day group(n=32)and 4-6 day group(n=35).In each group,it was divided into mild group and moderate-severe group.The complement in serum was detected by radial immunodiffusion assay with Behring Nephelometer 100 Analyzer.Results In 1-3 day group,levels of C_3,C_4 in serum were lower than those in control group(P
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Objective To investigate the expression of complement split product C4d and its significance in renal allograf tissue of chronic rejection in rats.Methods The healthy closed population Wister rats and SD rats were used as donator and acceptor in renal transplantation.The chronic rejection model of renal transplant in rats was established and the rats were divided into 2 groups.The rats in experimental group were given Mycophenolate mofetil(MMF)(10 mg/kg) and those of the control group were given nothing except CsA(5 mg?kg~(-1)?d~(-1)) for 10 days.At the 12th week of renal transplantation,the allograft was tested by light microscope,and the pathological changes of renal grafts and the expression of C4d in peritubular capillaries were observed.Results On the 12th week of renal transplantation,the morphology changes of chronic rejection was observed in the experimental group and obvious C4d deposition was detected in peritubular capillaries of renal allograft tissue,with significant difference compared with those of the control group(all P
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0.05).Furthermore,the mean survival time for renal allograft with CD20 and C4d double-positive was 32.2?12.3 months,and with C4d single-positive it was 81.2?15.6 months.Log-Rank test demonstrated that graft survival in recipients with both CD20 and C4d double-positive expression was significantly lower than that in recipients with C4d single-positive expression(P
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Objective To explore the significance of peritubular capillary C4d deposition in the diagnosis, treatment and prognosis of the patients with acute renal allograft rejection.Methods 86 allograft biopsies obtained from 78 kidney transplants were examined by immunohistochemistry on routine paraffin sections using anti-C4d polyclonal antibody. The relationship of C4d and functions, therapies and prognoses of allografts was analyzed. Results There were 32 allograft biopsies with Banff type Ⅰ rejection, 51 with Banff type Ⅱ rejection and 3 with Banff type Ⅲ rejection. Thirty biopsies were positive in C4d deposition. For 28 patients, at least one biopsy exhibited peritubular C4d deposition. There was no significant difference between type Ⅰ and type Ⅱ rejection ( 21.9 % vs 39.2 % , P= 0.101 ). The C4d~ + group had proportionately more patients with pregnant history (P= 0.020 ), more patients with high panel-reactive antibody levels (P= 0.013 ), and more retransplanted patients (P= 0.016 ). Mean serum creatinine was significantly higher in C4d positive patients than in negative patients[( 312.56 ? 196.26 ) ?mol/L vs ( 210.97 ? 136.59 ) ?mol/L, P= 0.0115 ]. Patients with C4d deposition were more commonly resistant to antirejection therapy with bolus steroids ( 75.0 % vs 28.0 % , P= 0.000 ) and ATG ( 66.7 % vs 12.5 % , P= 0.027 ). More patients with peritubular C4d deposition lost their grafts during the study period (64.3 % vs 90.0 %, P= 0.006 ).Conclusion Acute rejection with C4d deposition were resistant to antirejection therapy with steroids and/or ATG, and associated with inferior graft outcome.
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Objective To explore the significance of complement split product C4d in monitoring chronic rejection of renal allografts in rats.Methods Healthy closed population rats were used as donors and SD rats as recipients. The Wistar to SD model of graft rejection was developed. All the 42 recipients were randomly divided into 2 groups: group A receiving nothing except CsA (5mg?kg~ -1 ? d~ -1 ) in the first 10 days after operation, and group B receiving MMF (10 mg/kg) and CsA after operation. On the 3rd, 5th and 10th week, all the allografts were tested by light microscopy and immunofluorescence. Pathological changes of the kidneys and the expression of C4d in allograft tissue were observed.Results From the 3rd week, the rats in group A showed light pathological changes of chronic rejection and they became more and more obvious as time increased. Pathological changes occurred in group B at the 5th week and lighter than in group A. At the same time, C4d deposition in PTC was obviously observed on the 3rd week in group A, and on the 10th week C4d widespread deposition in allografts.Conclusion The deposition of complement split product C4d in allografts appears earlier than pathological change of chronic rejection, which can be regarded as a significant indicator to predict chronic rejection of renal allografts.