C-reactive protein-mediated complement activation in polymyalgia rheumatica and other systemic inflammatory diseases.
An immunoglobulin-independent deposition of the complement (C) components C4 and C3 occurs on rat kidney medullary structures, when sera of patients with various inflammatory diseases are studied by indirect immunofluorescence. The diagnostic value of this new test (C4-C3-IFT) for polymyalgia rheumatica (PMR) is stressed, since all sera from patients with active disease yielded positive reactions. Though highly sensitive with respect to PMR, C4/C3-IFT is not specific for this syndrome. Examples of positive reactions in systemic inflammatory diseases other than PMR are documented. Besides the clinical studies, C4/C3-IFT reactivity was analyzed with regard to the mechanisms of the reaction. Experimental data are presented which suggest that C-reactive protein (CRP) binds to rat kidney structures, thereby activating the classical C cascade. As a result of CRP-C interaction, C4 and C3 components are fixed to distinct renal medullary structures. Because of its technical simplicity, C4/C3-IFT can routinely be used to screen patients' sera for CRP-mediated C activation. This ex vivo test system may contribute to a better understanding of pathophysiological functions of serum CRP in various inflammatory diseases.
Vaith
P
P
Department of Rheumatology and Clinical Immunology, Medical University Clinic, Freiburg, Federal Republic of Germany.
Hänsch
G M
GM
Peter
H H
HH
D000936:Antigen-Antibody Complex / Q000378:metabolism / Q000502:physiology; D001798:Blood Proteins / Q000032:analysis; D002097:C-Reactive Protein / Q000378:metabolism / Q000494:pharmacology / Q000502:physiology*; D002118:Calcium; D003167:Complement Activation; D003172:Complement C1 / Q000494:pharmacology; D006358:Hot Temperature; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007679:Kidney Medulla / Q000032:analysis; D008722:Methods; D011111:Polymyalgia Rheumatica / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D011480:Protease Inhibitors / Q000494:pharmacology; D012216:Rheumatic Diseases / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology
D000936:Antigen-Antibody Complex; D001798:Blood Proteins; D003172:Complement C1; D007074:Immunoglobulin G; D011480:Protease Inhibitors; D002097:C-Reactive Protein; D002118:Calcium