ReviewKidney international2012
Pros and cons for C4d as a biomarker.
Review in Kidney international, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
81 citing papers in PubMed, 209 citations in OpenAlex.
- Biomarkers in the Management of Complement-Mediated Kidney Diseases in the Era of Complement Therapeutics.Clinical journal of the American Society of Nephrology : CJASN · 2026Review
- An observational study on mesangial C4d staining as a prognostic tool in IgA nephropathy.Journal of nephrology · 2025Observational
- The grand escape - how pathogens outsmart the human complement system.Immunobiology · 2025Review
- Relationship between complement and macrophage markers with kidney survival in patients with diabetic nephropathy.Acta diabetologica · 2025Article
- Emerging roles for complement in lung transplantation.The Journal of clinical investigation · 2025Review
- C4d Immunoreactivity in Autoimmune and HBV-Induced Hepatitis: Implications for Complement-Mediated Hepatocellular Injury.Pathophysiology : the official journal of the International Society for Pathophysiology · 2025Article
- A Novel Perspective on Tubular C4d Positivity in BK Polyomavirus Nephropathy.Kidney international reports · 2025Article
- B Cell Tolerance and Obstetric Antiphospholipid Syndrome.Clinical reviews in allergy & immunology · 2025Review
- Complement in Antibody-Mediated Rejection of the Kidney Graft: From Pathophysiology to Clinical Practice.Journal of clinical medicine · 2025Review
- Association of C4d with disease activity in anti-neutrophil cytoplasmic antibody-associated vasculitis: evidence for classical/lectin complement pathway activation.Arthritis research & therapy · 2025Article
- A new index for the outcome of focal segmental glomerulosclerosis.Scientific reports · 2024Article
- New insights into neuropathology and pathogenesis of autoimmune glial fibrillary acidic protein meningoencephalomyelitis.Acta neuropathologica · 2024Article
- Transcriptomic signatures of chronic active antibody-mediated rejection deciphered by RNA sequencing of human kidney allografts.Kidney international · 2024Article
- Significance of C4d expression in peritubular capillaries concurrent with microvascular inflammation in for-cause biopsies of ABO-incompatible renal allografts.Kidney research and clinical practice · 2024Article
- Clinicopathological differences in focal segmental glomerulosclerosis depending on the accompanying pathophysiological conditions in renal allografts.Virchows Archiv : an international journal of pathology · 2023Article
- Early Cytomegalovirus Reactivation in Renal Recipients Is Associated with High Levels of B Cell Maturation Antigen Transcript Expression Prior to Transplantation.International journal of molecular sciences · 2023Article
- Association between glomerular C4d deposition, proteinuria, and disease severity in children with IgA nephropathy.Pediatric nephrology (Berlin, Germany) · 2023Article
- HLA class II antibody activation of endothelial cells induces M2 macrophage differentiation in peripheral blood.Clinical and experimental nephrology · 2023Article
- ABO-incompatible living donor kidney transplantation failure due to acute blood group antibody-dependent rejection triggered by human parvovirus B19 infection: a case report and literature review.Frontiers in medicine · 2023Article
- Extracellular vesicles: a potential new player in antibody-mediated rejection in lung allograft recipients.Frontiers in transplantation · 2023Article
21 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 4 countries.
Funding
Abstract
The introduction of C4d in daily clinical practice in the late nineties aroused an ever-increasing interest in the role of antibody-mediated mechanisms in allograft rejection. As a marker of classical complement activation, C4d made it possible to visualize the direct link between anti-donor antibodies and tissue injury at sites of antibody binding in a graft. With the expanding use of C4d worldwide several limitations of C4d were identified. For instance, in ABO-incompatible transplantations C4d is present in the majority of grafts but this seems to point at 'graft accommodation' rather than antibody-mediated rejection. C4d is now increasingly recognized as a potential biomarker in other fields where antibodies can cause tissue damage, such as systemic autoimmune diseases and pregnancy. In all these fields, C4d holds promise to detect patients at risk for the consequences of antibody-mediated disease. Moreover, the emergence of new therapeutics that block complement activation makes C4d a marker with potential to identify patients who may possibly benefit from these drugs. This review provides an overview of the past, present, and future perspectives of C4d as a biomarker, focusing on its use in solid organ transplantation and discussing its possible new roles in autoimmunity and pregnancy.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.