title: Glomerular deposition of the complement C4 isotypes C4A and C4B in glomeruonephritis.
abstract: BACKGROUND
  Complement C4 is a component of the classical complement pathway, which is a major mediator of inflammation in many forms of glomerulonephritis. The two isoforms of C4-C4A and C4B-differ in their physicochemical and functional properties.
  
  
  METHODS
  The glomerular deposition of C4A and C4B was investigated in 39 cases of glomerulonephritis with classical pathway activation using isotype-specific monoclonal antibodies 99H7 (C4A) and 1288 (C4B) and indirect immunofluorescence. Complement C4 phenotypes of all patients were determined by agarose gel electrophoresis and immunoprecipitation.
  
  
  RESULTS
  Three biopsies contained only the isotype C4B. C4 phenotyping revealed complete C4A deficiency in these three patients. Both isotypes C4A and C4B were detected in 36 biopsies. In 19 (53%) thereof staining for both isotypes was identical. In the remaining 17 (47%), staining intensity of C4A predominated over C4B. The distribution of these two staining patterns did not differ between membranous glomerulonephritis and lupus nephritis. They were also independent of C4A and C4B allotypes including the presence or absence of null alleles at either gene locus. In no case was C4B staining stronger than C4A staining. Serum creatinine and proteinuria did not differ between patients with identical and C4A-dominant C4 deposition.
  
  
  CONCLUSIONS
  The most likely but still hypothetical explanation for predominance in glomerular deposition of C4A over C4B in many cases of immune complex-mediated glomerulonephritis is the greater affinity of C4A to protein-containing immune complexes as compared to C4B.
authors.affiliation: Department of Internal Medicine, Innsbruck University Hospital and Instute of Medical Biology and Human Genetics, University of Innsbruck, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Lhotta
authors.forename: A
authors.initials: A
authors.lastname: Schlogl
authors.forename: F
authors.initials: F
authors.lastname: Kronenberg
authors.forename: M
authors.initials: M
authors.lastname: Joannidis
authors.forename: P
authors.initials: P
authors.lastname: Konig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003181:Complement C4 / Q000235:genetics; D015934:Complement C4a / Q000378:metabolism*; D015935:Complement C4b / Q000378:metabolism*; D005260:Female; D005455:Fluorescent Antibody Technique; D005921:Glomerulonephritis / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007678:Kidney Glomerulus / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D013194:Staining and Labeling
chemical_list: D003181:Complement C4; D015934:Complement C4a; D015935:Complement C4b