title: Glomerular C4d deposition indicates in situ classic complement pathway activation, but is not a marker for lupus nephritis activity.
abstract: This study was designed to evaluate whether glomerular C4d deposition may be a useful marker of lupus nephritis activity. Twenty-one patients diagnosed as having lupus nephritis (WHO class III: 4 cases; IV: 12 cases; V: 5 cases) were included. Mean patient age was 29.3 +/- 13.5 years (range: 7-55 years). The presence and intensity of glomerular C4d deposition were compared with the corresponding histologic activity index for each case. Immunofluorescence for C4d showed diffusely granular staining along glomerular capillary loops, in all cases examined (1+, in 8 cases; 2+, in 7 cases; 3+, in 6 cases). In eight cases, C4d deposition was found in the absence of capillary or mesangial C4 deposits. Moreover, the intensity of C4d deposits correlated with those of capillary IgG, IgA, C4, C1q, and fibrinogen deposits. However, C4d staining intensity did not correlate with the lupus nephritis activity index. Although glomerular capillary C4d deposition is a sensitive marker of classic complement pathway activation, it is not a sensitive marker for active lupus nephritis.
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, 134 Shinchon- dong, Seodaemun-gu, Seoul 120-752, Korea. jeong10@yumc.yonsei.ac.kr
authors.forename: Se Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Hyeon Joo
authors.initials: HJ
authors.lastname: Jeong
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D002648:Child; D003181:Complement C4 / Q000378:metabolism*; D015935:Complement C4b; D003171:Complement Pathway, Classical / Q000502:physiology*; D005260:Female; D006801:Humans; D007678:Kidney Glomerulus / Q000378:metabolism*; D008181:Lupus Nephritis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000378:metabolism*; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D003181:Complement C4; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d