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Clinical significance of C4d deposition in renal tissues from patients with primary Sjogren's syndrome-a preliminary study.

ABSTRACT:

Background

To evaluate renal expression of C4d, a complement component in the classical/mannose binding lectin (MBL) pathway, in patients with primary Sjögren's syndrome (pSS)-associated renal impairments.

Methods

We retrospectively reviewed the clinical and pathological data from 39 patients with pSS presenting with renal impairments. C4d was examined in paraffin-embedded biopsy tissues using immunohistochemistry. Glomerular C4d positive was defined when >?75% glomeruli were globally stained. Tubulointerstitial C4d (TI-C4d) were scored semi-quantitatively as 0 (absent), 1 (spotty or weak), 2 (patchy) and 3 (diffuse). A TI-C4d score???2 was considered TI-C4d positive and included in the TI-C4d⁺ group and vice versa. Peritubular capillary (PTC) C4d was scored as 0 (absent), 1 (0~10%, minimal), 2 (10%~?50%, focal), and 3 (>?50%, diffuse).

Results

Glomerular C4d deposition was observed in all 8 patients with pSS-related membranous nephropathy (MN) without obvious C1q deposition. Two of 5 patients with mesangial proliferative glomerulonephritis and 1 of 2 patients with IgA nephropathy had mild mesangial C4d deposition. Sixteen patients (6 glomerular dominant and 10 tubulointerstitial dominant) presented TI-C4d score???2. Patients in the TI-C4d⁺ group exhibited a higher serum creatinine level at the time of renal biopsy (TI-C4d⁺ 132.5 [89.7, 165.5] vs. TI-C4d^- 83.0 [70.7, 102.0] ?mol/L, P?=?0.008). PTC C4d was observed in 12 patients, with each of minimal, focal and diffuse staining being noted in 4 patients.

Conclusions

The MBL pathway of complement activation was potentially involved in pSS-related MN. Tubulointerstitial C4d might be a pathological marker of severe renal injury in patients with pSS-related renal impairments.

SUBMITTER: Xia W

PROVIDER: S-EPMC6540533 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Clinical significance of C4d deposition in renal tissues from patients with primary Sjögren's syndrome-a preliminary study.

Xia Wenli W Gao Bixia B Duan Lin L Li Yan Y Wen Yubing Y Chen Limeng L Li Xuemei X Zheng Falei F Li Mingxi M

BMC nephrology 20190528 1

<h4>Background</h4>To evaluate renal expression of C4d, a complement component in the classical/mannose binding lectin (MBL) pathway, in patients with primary Sjögren's syndrome (pSS)-associated renal impairments.<h4>Methods</h4>We retrospectively reviewed the clinical and pathological data from 39 patients with pSS presenting with renal impairments. C4d was examined in paraffin-embedded biopsy tissues using immunohistochemistry. Glomerular C4d positive was defined when > 75% glomeruli were glob ...[more]

PMID: 31138153

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