ABSTRACT
La glomerulonefritis membranoproliferativa mediada por complemento es una enfermedad rara, pero puede asociarse a alteraciones retinianas. Por ello, el propósito de este estudio fue valorar una serie de casos con dicho diagnóstico en seguimiento por nefrología en nuestro centro. Se realizó un estudio transversal de 8 pacientes diagnosticados de glomerulonefritis membranoproliferativa mediada por complemento. Se realizó funduscopia, tomografía de coherencia óptica (OCT) y angio-OCT de dominio Swept Source. Uno de los 8 pacientes presentaba depósitos drusenoides que se localizaron bajo el epitelio pigmentario retiniano en la OCT, descartándose la presencia de neovascularización coroidea asociada en la angio-OCT. Por tanto, la glomerulonefritis membranoproliferativa puede producir alteraciones retinianas con drusas o desprendimientos del epitelio pigmentario retiniano, por lo que debe hacerse un adecuado diagnóstico diferencial con la degeneración macular asociada a la edad. Es crucial realizar un seguimiento en estos pacientes ante las posibles complicaciones que pueden desembocar en una pérdida de visión
Complement-mediated membranoproliferative glomerulonephritis is a rare progressive glomerular disease. In some patients it can be associated with retinal lesions. Therefore, the purpose of this study was to assess a case series with this diagnosis in our hospital. A cross-sectional study was conducted on 8 patients diagnosed with complement-mediated membranoproliferative glomerulonephritis. Funduscopy, optical coherence tomography (OCT) and Swept Source domain OCT angiography were performed. Only 1 of the 8 patients showed drusen-like deposits that were located under the retinal pigment epithelium in the OCT, with the presence of associated choroidal neovascularization being ruled out in OCT angiography. Therefore, membranoproliferative glomerulonephritis may produce retinal alterations with drusen or retinal pigment epithelium detachment, and requires an appropriate differential diagnosis to be made with age-related macular degeneration. The follow-up of these patients is important in order to detect vision-threatening complications
Subject(s)
Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Glomerulonephritis, Membranoproliferative , Retina/pathology , Patients/classification , Tomography/classification , Epithelium/pathology , Retinal Drusen/classification , Macular Degeneration/classification , Macular Degeneration/diagnosisABSTRACT
Complement-mediated membranoproliferative glomerulonephritis is a rare progressive glomerular disease. In some patients it can be associated with retinal lesions. Therefore, the purpose of this study was to assess a case series with this diagnosis in our hospital. A cross-sectional study was conducted on 8 patients diagnosed with complement-mediated membranoproliferative glomerulonephritis. Funduscopy, optical coherence tomography (OCT) and Swept Source domain OCT angiography were performed. Only 1 of the 8 patients showed drusen-like deposits that were located under the retinal pigment epithelium in the OCT, with the presence of associated choroidal neovascularization being ruled out in OCT angiography. Therefore, membranoproliferative glomerulonephritis may produce retinal alterations with drusen or retinal pigment epithelium detachment, and requires an appropriate differential diagnosis to be made with age-related macular degeneration. The follow-up of these patients is important in order to detect vision-threatening complications.
Subject(s)
Glomerulonephritis, Membranoproliferative/complications , Retinal Diseases/etiology , Adult , Aged , Aged, 80 and over , Angiography , Complement Activation , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Ophthalmoscopy , Retinal Drusen/etiology , Tomography, Optical Coherence , Young AdultABSTRACT
New putative antigenic peptides corresponding to the N- and C-terminal of the E2 envelope protein of GBV-C/HGV were synthesized using solid-phase chemistry. The antigens were obtained in linear and chimeric forms with the main aim of improving the sensitivity of the enzyme immunoassays. Furthermore, CD and FTIR have been used in conjunction to characterize their conformational changes showing that the chimeric peptide presents a more ordered secondary structure than its parent peptides.
Subject(s)
Flaviviridae Infections/diagnosis , GB virus C/immunology , Hepatitis, Viral, Human/diagnosis , Peptides/chemical synthesis , Serologic Tests/methods , Amino Acid Sequence , Circular Dichroism , Enzyme-Linked Immunosorbent Assay , Epitopes/immunology , Flaviviridae Infections/virology , Hepatitis, Viral, Human/virology , Humans , Molecular Sequence Data , Peptides/chemistry , Peptides/immunology , Protein Structure, Secondary , ROC Curve , Spectroscopy, Fourier Transform Infrared , Viral Envelope Proteins/chemistryABSTRACT
In this work, we present a structural characterization of the putative fusion peptide E2(279-298) corresponding to the E2 envelope protein of the HGV/GBV-C virus by (1)H NMR, CD and MD studies performed in H(2)O/TFE and in lipid model membranes. The peptide is largely unstructured in water, whereas in H(2)O/TFE and in model membranes it adopts an helical structure (approximately 65-70%). The partitioning free energy DeltaG ranges from -6 to -7.5 kcal mol(-1). OCD measurements on peptide-containing hydrated and oriented lipid multilayers showed that the peptide adopts a predominantly surface orientation. The (1)H NMR data (observed NOEs, deuterium exchange rates, Halpha chemical shift index and vicinal coupling constants) and the molecular dynamics calculations support the conclusions that the peptide adopts a stable helix in the C-terminal 9-18 residues slightly inserted into the lipid bilayer and a major mobility in the amino terminus of the sequence (1-8 residues).
