Evidence map›Paper›PMID 41236837›Full record

ArticleArthritis & rheumatology (Hoboken, N.J.)2026

Distinct Effects of Complement C4A and C4B Copy Numbers in Systemic Sclerosis Serological and Clinical Subtypes.

Javier Martínez-López, Carlos Rangel-Peláez, Inmaculada Rodriguez-Martin, Alfredo Guillen-Del-Castillo, Carmen P Simeón-Aznar, José L Callejas, Oliver Distler, International SSc Group, PRECISESADs Clinical Consortium, Susanna M Proudman and 15 more

Abstract read
In one paragraph

Article in Arthritis & rheumatology (Hoboken, N.J.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Javier Martínez-LópezInstitute of Parasitology and Biomedicine López-Neyra, Consejo Superior de Investigaciones Cientificas, Granada, Spain.ORCID https://orcid.org/0000-0003-0184-9543
Carlos Rangel-PeláezInstitute of Parasitology and Biomedicine López-Neyra, Consejo Superior de Investigaciones Cientificas, Granada, Spain.ORCID https://orcid.org/0000-0001-7697-1696
Inmaculada Rodriguez-MartinInstitute of Parasitology and Biomedicine López-Neyra, Consejo Superior de Investigaciones Cientificas, Granada, Spain.
Alfredo Guillen-Del-CastilloUnit of Systemic Autoimmune Diseases, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Carmen P Simeón-AznarUnit of Systemic Autoimmune Diseases, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
José L CallejasSystemic Autoimmune Disease Unit, Hospital Universitario Clínico San Cecilio, Instituto de Investigación Biosanitaria, Granada, Spain.
Oliver DistlerDepartment of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0002-0546-8310
International SSc Group
PRECISESADs Clinical Consortium
Susanna M ProudmanRoyal Adelaide Hospital and the University of Adelaide, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0002-3046-9884
Mandana NikpourDepartment of Medicine, University of Melbourne, Fitzroy, Victoria, Australia.
Australian Scleroderma Interest Group (ASIG)
Nicolas HunzelmannDepartment of Dermatology, University of Cologne, Cologne, Germany.
Gianluca MoronciniDepartment of Clinical and Molecular Science, Marche Polytechnic University, Ancona, Italy.
Jeska K de Vries-BouwstraThe Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands.
Ariane L HerrickThe University of Manchester, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.ORCID https://orcid.org/0000-0003-4941-7926
Yannick AllanoreDepartment of Rheumatology, Université Paris Cité UFR de Médecine, Paris, France.
Marta E Alarcon-RiquelmeCentre for Genomics and Oncological Research, Pfizer, University of Granada/Andalusian Regional Government, Granada, Spain.
Lorenzo BerettaScleroderma Unit, Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.ORCID https://orcid.org/0000-0002-6529-6258
Shervin AssassiDepartment of Internal Medicine, Division of Rheumatology, The University of Texas Health Science Center at Houston.ORCID https://orcid.org/0000-0002-8059-9978
Christopher P DentonCentre for Rheumatology, Royal Free Hospital, University College London, London, United Kingdom.ORCID https://orcid.org/0000-0003-3975-8938
Maureen D MayesDepartment of Internal Medicine, Division of Rheumatology, The University of Texas Health Science Center at Houston.ORCID https://orcid.org/0000-0001-5070-2535
Javier MartinInstitute of Parasitology and Biomedicine López-Neyra, Consejo Superior de Investigaciones Cientificas, Granada, Spain.
Marialbert Acosta-HerreraInstitute of Parasitology and Biomedicine López-Neyra, Consejo Superior de Investigaciones Cientificas, Granada, Spain.ORCID https://orcid.org/0000-0002-9868-6535
Martin KerickInstitute of Parasitology and Biomedicine López-Neyra, Consejo Superior de Investigaciones Cientificas, Granada, Spain.

Funding

Innovative Medicines Initiative Joint Undertaking 115565Instituto de Salud Carlos III FI23/00231Instituto de Salud Carlos III PI22/00092Instituto de Salud Carlos III RD21/0002/0039Instituto de Salud Carlos III RD24/0007/0016Ministerio de Ciencia e Innovación PID2022-13929208-I00Spainsh Ministry of Science, Innovation and Universities PREP2022-000747Spanish Ministry of University FPU21/02746
6 · The paper itself

Abstract

objectiveComplement component 4 (C4), encoded by C4A and C4B within the major histocompatibility complex (MHC) on chromosome 6, regulates the immune response and clears immune complexes. The variable copy number (CN) of C4 genes and retroviral human endogenous retrovirus K (HERV-K) element influence its function. Given the relationship of C4 CN with systemic sclerosis (SSc) risk, we assessed associations with SSc clinical and serologic subtypes.

methodsWe compared imputed C4 CNs across SSc subgroups (4,049 anticentromere positive [ACA

resultsLower C4 CN and higher HERV-K CN were associated with increased risk in all SSc subgroups. ATA

conclusionThis study highlights distinct genetic contributions of C4A and C4B in SSc subtypes susceptibility. Our findings suggest that lower C4 CNs, particularly C4A, increase the risk of the severe dcSSc subtype, potentially through a mechanism involving immune complex clearance.

Indexed as

Complement C4aComplement C4bScleroderma, SystemicAdultAgedAntibodies, AntinuclearAutoantibodiesDNA Copy Number VariationsEndogenous RetrovirusesFemaleGene DosageHumansMaleMiddle AgedScleroderma, DiffuseScleroderma, LimitedAntibodies, AntinuclearAutoantibodiesComplement C4aComplement C4b

Identifiers

PMID41236837
PMCPMC13054456

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Registered trials

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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.