title: All Things Complement.
abstract: The complement (C) cascade is an ancient system of proteins whose primary role is to initiate and modulate immune responses. During C activation, circulating proteins are cleaved and nascent cleavage fragments participate in a broad range of downstream innate and adaptive immune functions. Although the majority of these functions are either homeostatic or protective, a large body of experimental and clinical evidence also highlights a central role for the C system in the pathogenesis of many types of glomerular disease. From classic pathway activation in lupus nephritis to alternative pathway dysregulation in C3 glomerulopathy, our understanding of the spectrum of C involvement in kidney disease has expanded greatly in recent years. However, the characteristics that make the glomerulus so uniquely susceptible to C-mediated injury are not fully understood, and this remains an area of ongoing investigation. Several C inhibitors have been approved for clinical use, and additional C inhibitory drugs are in development. The use of these drugs in patients with kidney disease will expand our understanding of the benefits and limitations of C inhibition.
authors.affiliation: Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado; and.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Thurman
authors.affiliation: Stead Family Department of Pediatrics and.|Department of Internal Medicine, University of Iowa, Iowa City, Iowa.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Nester
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D003167:Complement Activation; D003165:Complement System Proteins / Q000378:metabolism*; D004195:Disease Models, Animal; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D007678:Kidney Glomerulus / Q000473:pathology
chemical_list: D015415:Biomarkers; D003165:Complement System Proteins
keywords: Complement Activation; Complement Inactivating Agents; Complement System Proteins; Humans; Kidney Diseases; Kidney Glomerulus; clinical immunology; complement; glomerular disease; glomerulonephritis; immune complexes; lupus nephritis