Urinary markers of the alternative and lectin complement pathway are increased in IgA vasculitis nephritis.

Marro, Julien ORCID: 0000-0003-4954-7915, Chetwynd, Andrew J ORCID: 0000-0001-6648-6881, Hawkes, Jennifer, Northey, Sarah J and Oni, Louise ORCID: 0000-0002-1532-2390 (2023) Urinary markers of the alternative and lectin complement pathway are increased in IgA vasculitis nephritis. Clinical kidney journal, 16 (12). pp. 2703-2711.

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Abstract

<h4>Background</h4>IgA vasculitis (IgAV) is the most common form of childhood vasculitis. Nephritis (IgAVN) occurs in 50% of patients and 1-2% progress to chronic kidney disease stage 5. The pathophysiology of nephritis remains largely unknown, but recent evidence suggests that the complement system may be involved. The aim of this cross-sectional study was to explore whether there is evidence of alternative and/or lectin complement pathway activation in children with IgAVN.<h4>Methods</h4>Children with IgAV were recruited and grouped according to proteinuria: IgAVN or IgAV without nephritis (IgAVwoN). Age and sex-matched healthy controls (HCs) were also recruited. Cross-sectional urine and plasma concentrations of complement factor D (CFD), factor B (CFB), and MBL-associated protease 1 (MASP-1) were performed using commercially available enzyme-linked immunoassays.<h4>Results</h4>A total of 50 children were included (IgAVN, <i>n</i> = 15; IgAVwoN, <i>n</i> = 20, HCs, <i>n</i> = 15). The mean age was 8.5 ± 3.7 years old, male:female ratio was 1:1. Urinary CFD and CFB concentrations were statistically significantly increased in children with IgAVN (3.5 ± 5.4 μg/mmol; 25.9 ± 26.5 μg/mmol, respectively) compared to both IgAVwoN (0.4 ± 0.4 μg/mmol, <i>P</i> = 0.002; 9.2 ± 11.5 μg/mmol, <i>P</i> = 0.004) and HCs (0.3 ± 0.2 μg/mmol, <i>P</i> < 0.001; 5.1 ± 6.0 μg/mmol, <i>P</i> < 0.001). No statistically significant difference was reported for the plasma concentrations of CFD and CFB. Urinary MASP-1 concentrations were statistically significantly increased in IgAVN (116.9 ± 116.7 ng/mmol) compared to HCs (41.4 ± 56.1 ng/mmol, <i>P</i> = 0.006) and plasma MASP-1 concentrations were increased in IgAVwoN (254.2 ± 23.3 ng/mL) compared to HCs (233.4 ± 6.6 ng/mL, <i>P</i> = 0.046).<h4>Conclusion</h4>There is evidence of complement pathway products in the urine of children with IgAVN that warrants further investigation.

Item Type:	Article
Uncontrolled Keywords:	HSP, Henoch–Schonlein purpura, complement, kidney, paediatrics
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	07 Dec 2023 10:28
Last Modified:	15 Mar 2024 14:15
DOI:	10.1093/ckj/sfad236
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3177204