ArticleLupus science & medicine2022
Membrane attack complex (MAC) deposition in renal tubules is associated with interstitial fibrosis and tubular atrophy: a pilot study.
Article in Lupus science & medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 20 citations in OpenAlex.
- Clinical Value of Kidney Immunodeposits and Urinary Complement Activation Fragments in IgAN.Kidney international reports · 2026Article
- The Pathogenesis, Potential Biomarkers and Novel Therapeutic Strategies for Tubulointerstitial Nephritis in Systemic Lupus Erythematosus-A Narrative Review.International journal of molecular sciences · 2025Review
- HDAC3 knockdown inhibits ferroptosis via upregulating Nrf2 to alleviate renal interstitial fibrosis in lupus nephritis.Lupus science & medicine · 2025Article
- Urine proteins reveal distinct coagulation and complement cascades underlying acute versus chronic lupus nephritis.The Journal of clinical investigation · 2025Article
- Novel multifunctional targeted nanozyme as an ultrasound contrast agent for real-time monitoring and treatment of congenital hydronephrosis renal fibrosis.Journal of nanobiotechnology · 2025Article
- Urinary Biomarkers for Lupus Nephritis: A Systems Biology Approach.Journal of clinical medicine · 2024Review
- Macrophage Infiltration Correlated with IFI16, EGR1 and MX1 Expression in Renal Tubular Epithelial Cells Within Lupus Nephritis-Associated Tubulointerstitial Injury via Bioinformatics Analysis.Journal of inflammation research · 2024Article
- Integrative analysis of COL6A3 in lupus nephritis: insights from single-cell transcriptomics and proteomics.Frontiers in immunology · 2024Article
- Urinary complement biomarkers in immune-mediated kidney diseases.Frontiers in immunology · 2024Review
- Urine Proteomics Link Complement Activation with Interstitial Fibrosis/Tubular Atrophy in Lupus Nephritis Patients.Seminars in arthritis and rheumatism · 2023Article
- Microvascular C5b-9 deposition in non-lesional skin in patients with SLE and its correlation with active lupus nephritis: a prospective observational study.Lupus science & medicine · 2023Observational
- C3dg and MAC complement depositions in the renal histopathology of patients with lupus nephropathy.Translational pediatrics · 2023Article
- Renal Fibrosis in Lupus Nephritis.International journal of molecular sciences · 2022Review
- Current Insights on Biomarkers in Lupus Nephritis: A Systematic Review of the Literature.Journal of clinical medicine · 2022Review
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12 authors at 4 institutions in 2 countries.
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Abstract
introductionTreatment failures for lupus nephritis (LN) are high with 10%-30% of patients progressing to end-stage renal disease (ESRD) within 10 years. Interstitial fibrosis/tubular atrophy (IFTA) is a predictor of progression to ESRD. Prior studies suggest that tubulointerstitial injury secondary to proteinuria in LN is mediated by complement activation in the tubules, specifically through the membrane attack complex (MAC). This study aimed to investigate the associations between tubular MAC deposition with IFTA and proteinuria.
methodsIn this cross-sectional study, LN kidney biopsies were assessed for MAC deposition by staining for Complement C9, a component of the MAC. Chromogenic immunohistochemistry was performed on paraffin-embedded human renal biopsy sections using unconjugated, murine anti-human Complement C9 (Hycult Biotech, clone X197). Tubular C9 staining intensity was analysed as present versus absent. IFTA was defined as minimal (<10%), mild (10%-24%), moderate (25%-50%) and severe (>50%).
resultsRenal biopsies from 30 patients with LN were studied. There were 24 (80%) female sex, mean age (SD) was 33 (12) years old and 23 (77%) had pure/mixed proliferative LN. Tubular C9 staining was present in 7 (23%) biopsies. 27 patients had minimal-to-mild IFTA and 3 patients had moderate IFTA. Among the C9 + patients, 3 (43%) had moderate IFTA as compared with none in the C9- group, p=0.009. C9 + patients had higher median (IQR) proteinuria as compared with C9- patients: 6.2 g (3.3-13.1) vs 2.4 g (1.3-4.6), p=0.001 at the time of biopsy. There was no difference in estimated glomerular filtration rate (eGFR) between the C9 + and C9- groups.
conclusionThis study demonstrated that tubular MAC deposition is associated with higher degree of IFTA and proteinuria, which are predictors of progression to ESRD. These results suggest that tubular MAC deposition may be useful in classification of LN. Understanding the role of complement in tubulointerstitial injury will also identify new avenues for LN treatment.
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