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Renal filtration and catabolism of complement protein D.
- Source :
-
The New England journal of medicine [N Engl J Med] 1985 Feb 14; Vol. 312 (7), pp. 395-9. - Publication Year :
- 1985
-
Abstract
- Complement protein D, a serine protease participating in the formation of the C3 convertase of the alternative complement pathway, has the lowest molecular weight (23,750) and serum concentration of all complement proteins. In normal serum, D is the rate-limiting protease of the alternative pathway of complement activation. We report that the serum concentrations of D in 20 patients with chronic renal failure (mean +/- S.D., 0.42 +/- 0.28 mg per deciliter) and in 16 patients on long-term dialysis (1.53 +/- 0.39 mg per deciliter) were significantly higher (P less than 0.001) than in 22 healthy adults (0.18 +/- 0.04 mg per deciliter). In chronic renal failure the serum concentration of D correlated with that of creatinine (r = 0.75, P less than 0.001). The serum concentrations of D found in patients with renal failure reached and in some cases exceeded those at which the protease is no longer rate-limiting. Thus, enhanced activity of the alternative pathway of complement should be expected in patients with advanced renal failure. Urinary D was undetectable (less than 0.2 micrograms per deciliter) in 17 normal adults and either undetectable or below the concentration expected from the degree of proteinuria in 10 patients with nephrotic syndrome. However, in a patient with Fanconi's syndrome the urinary concentration of D (1.3 mg per deciliter) was an order of magnitude higher than the serum concentration, representing 0.5 per cent of the total protein. The urinary D in this patient had normal hemolytic activity, antigenicity, and size. These results indicate that D is filtered through the glomerular membrane and is probably catabolized in the proximal renal tubules.
- Subjects :
- Adult
Child
Complement C3-C5 Convertases biosynthesis
Complement Factor D blood
Complement Factor D urine
Complement Pathway, Alternative
Fanconi Syndrome enzymology
Female
Humans
Kidney Failure, Chronic enzymology
Male
Middle Aged
Nephrotic Syndrome enzymology
Renal Dialysis
Complement Activating Enzymes metabolism
Complement Factor D metabolism
Kidney enzymology
Subjects
Details
- Language :
- English
- ISSN :
- 0028-4793
- Volume :
- 312
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The New England journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 3844050
- Full Text :
- https://doi.org/10.1056/NEJM198502143120702