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Tytuł:
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Complement activation is associated with crescent formation in IgA nephropathy.
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Autorzy:
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Itami H; Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, Japan. .
Hara S; Department of Diagnostic Pathology, Kobe City Medical Center General Hospital, Kobe, Japan.
Samejima K; Department of Nephrology, Nara Medical University, Kashihara, Japan.
Tsushima H; Department of Nephrology, Nara Medical University, Kashihara, Japan.
Morimoto K; Department of Nephrology, Nara Prefecture General Medical Center, Nara, Japan.
Okamoto K; Department of Nephrology, Saiseikai Suita Hospital, Suita, Japan.
Kosugi T; Department of Nephrology, Nara Prefectural Seiwa Medical Center, Sango, Japan.
Kawano T; Department of Diabetes, Minami-Nara General Medical Center, Oyodo, Japan.
Fujiki K; Department of Diabetes, Minami-Nara General Medical Center, Oyodo, Japan.
Kitada H; Department of Internal Medicine, Saiseikai Chuwa Hospital, Sakurai, Japan.
Hatakeyama K; Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, Japan.
Tsuruya K; Department of Nephrology, Nara Medical University, Kashihara, Japan.
Ohbayashi C; Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, Japan.
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Źródło:
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Virchows Archiv : an international journal of pathology [Virchows Arch] 2020 Oct; Vol. 477 (4), pp. 565-572. Date of Electronic Publication: 2020 Apr 16.
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Typ publikacji:
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Journal Article; Multicenter Study
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Język:
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English
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Imprint Name(s):
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Original Publication: Berlin ; New York : Springer International, c1994-
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MeSH Terms:
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Complement Activation*
Complement System Proteins/*analysis
Glomerulonephritis, IGA/*immunology
Immunoglobulin A/*analysis
Kidney Glomerulus/*immunology
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Complement C3/analysis ; Complement Factor B/analysis ; Complement Membrane Attack Complex/analysis ; Female ; Fluorescent Antibody Technique ; Glomerulonephritis, IGA/pathology ; Humans ; Immunoglobulin Light Chains/analysis ; Japan ; Kidney Glomerulus/pathology ; Male ; Mannose-Binding Protein-Associated Serine Proteases/analysis ; Microscopy, Fluorescence ; Middle Aged ; Properdin/analysis ; Retrospective Studies ; Young Adult
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Contributed Indexing:
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Keywords: Complement; Crescents; IgA nephropathy; Light chain
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Substance Nomenclature:
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0 (C3 protein, human)
0 (Complement C3)
0 (Complement Membrane Attack Complex)
0 (Immunoglobulin A)
0 (Immunoglobulin Light Chains)
11016-39-0 (Properdin)
9007-36-7 (Complement System Proteins)
EC 3.4.21.- (Mannose-Binding Protein-Associated Serine Proteases)
EC 3.4.21.47 (Complement Factor B)
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Entry Date(s):
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Date Created: 20200418 Date Completed: 20201007 Latest Revision: 20201007
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Update Code:
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20240104
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DOI:
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10.1007/s00428-020-02800-0
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PMID:
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32300880
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IgA nephropathy (IgAN) is common chronic glomerulonephritis with variable prognosis, ranging from minor urinary abnormalities to end-stage renal disease. The revised Oxford classification of IgAN explains that cellular/fibrocellular crescents are associated with poor renal prognosis, proposing an extension to the MEST-C score. C3 immunofluorescent staining follows a distribution similar to IgA staining. Therefore, complement activation was reported to play a pivotal role in IgAN pathogenesis. This study included 132 IgAN patients diagnosed by renal biopsies. The clinical parameters at the time of the biopsies were obtained from patient data records. We classified the patients into C ≥ 1 and C0 groups, and compared clinical, light microscopic, and immunofluorescent features. In the C ≥ 1 group, 2 (1.5%) and 31 (23.5%) patients were assigned to C2 and C1, respectively. The remaining 99 patients (75%) were classified as C0. The C ≥ 1 group had lower average age and rate of hypertension, and higher score of urinary occult blood and E score. The C ≥ 1 group had significantly higher average immunofluorescence scores for IgA, C5b-9, mannose-associated serine protease (MASP) 1/3, MASP2, properdin, factor B, and kappa. The steroid use rate was significantly higher in the C ≥ 1 group. During the follow-up period of 2.90 years on average, the rate of renal dysfunction was not significantly different between groups. Crescent formation in IgAN was associated with activation of the lectin and alternative pathways. The C ≥ 1 group had significantly increased use of steroids, which probably caused comparable renal function during the follow-up period.