title: Terminal complement complexes in childhood type I membranoproliferative glomerulonephritis.
abstract: BACKGROUND
  The role of terminal complement complexes (TCCs), which are the final products of complement activation, in the pathogenesis of human glomerulonephritis has not been completely elucidated. To clarify the clinical significance of TCCs in type I membranoproliferative glomerulonephritis (MPGN), we studied TCCs in plasma, renal tissue and urine in pediatric patients with this disease.
  
  
  METHODS
  We measured the concentrations of TCC in plasma (n=25) and urine (n=13) using enzyme-linked immunosorbent assay. Frozen tissue from 18 renal biopsies were evaluated for the presence of TCC by direct immu-noperoxidase staining.
  
  
  RESULTS
  At the early stage of the disease, TCC concentrations in plasma were elevated to above 0.5 arbitrary units (AU)/mL in 14 of 25 patients (high-TCC group), while the remaining 11 patients showed less than 0.5 AU/mL (low-TCC group). In the high-TCC group, TCCs were deposited more diffusely and intensely in the glomerulus, compared with those in the low-TCC group (p=0.034). Furthermore, urinary TCC concentrations in the high-TCC group were higher than those in the low-TCC group (p=0.0001). The high-TCC group showed not only a poorer response to steroid treatment, but also poorer prognosis than the low-TCC group.
  
  
  CONCLUSIONS
  These results suggest that, in pediatric patients with type I MPGN, TCCs in circulation may play a particular role in TCC formation in the glomerulus and in urine. The TCC concentration in plasma could be used as a marker of responsiveness to steroid treatment and long-term prognosis.
authors.affiliation: Division of Pediatrics, Ashikaga Red Cross Hospital, Tochigi, Japan. y.kobayashi@ashikaga.jrc.or.jp
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Hasegawa
authors.forename: Masataka
authors.initials: M
authors.lastname: Honda
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002648:Child; D015938:Complement Membrane Attack Complex / Q000032:analysis* / Q000652:urine*; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000097:blood* / Q000188:drug therapy / Q000473:pathology / Q000652:urine*; D006801:Humans; D007678:Kidney Glomerulus / Q000378:metabolism; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D015938:Complement Membrane Attack Complex; D011239:Prednisolone