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Characterization of a factor H mutation that perturbs the alternative pathway of complement in a family with membranoproliferative GN

Wong, Edwin K.S., Anderson, Holly E., Herbert, Andrew P., Challis, Rachel C., Brown, Paul, Reis, Geisilaine, Tellez, James O., Strain, Lisa, Fluck, Nicholas, Humphrey, Ann, Macleod, Alison, Richards, Anna, Ahlert, Daniel, Santibanez-Koref, Mauro, Barlow, Paul N., Marchbank, Kevin J., Harris, Claire, Goodship, Timothy H.J. and Kavanagh, David 2014. Characterization of a factor H mutation that perturbs the alternative pathway of complement in a family with membranoproliferative GN. Journal of the American Society of Nephrology 25 (11) , pp. 2425-2433. 10.1681/ASN.2013070732

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Complement C3 activation is a characteristic finding in membranoproliferative GN (MPGN). This activation can be caused by immune complex deposition or an acquired or inherited defect in complement regulation. Deficiency of complement factor H has long been associated with MPGN. More recently, heterozygous genetic variants have been reported in sporadic cases of MPGN, although their functional significance has not been assessed. We describe a family with MPGN and acquired partial lipodystrophy. Although C3 nephritic factor was shown in family members with acquired partial lipodystrophy, it did not segregate with the renal phenotype. Genetic analysis revealed a novel heterozygous mutation in complement factor H (R83S) in addition to known risk polymorphisms carried by individuals with MPGN. Patients with MPGN had normal levels of factor H, and structural analysis of the mutant revealed only subtle alterations. However, functional analysis revealed profoundly reduced C3b binding, cofactor activity, and decay accelerating activity leading to loss of regulation of the alternative pathway. In summary, this family showed a confluence of common and rare functionally significant genetic risk factors causing disease. Data from our analysis of these factors highlight the role of the alternative pathway of complement in MPGN.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: Q Science > QR Microbiology > QR180 Immunology
Publisher: American Society of Nephrology
ISSN: 1046-6673
Date of Acceptance: 8 March 2014
Last Modified: 05 Mar 2020 03:30

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