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The Influence of Donor and Recipient Complement C3 Polymorphisms on Liver Transplant Outcome. Int J Hepatol 2021; 2021:6636456. [PMID: 34123432 PMCID: PMC8168477 DOI: 10.1155/2021/6636456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/27/2021] [Indexed: 12/19/2022] Open
Abstract
Despite early reports of an impact of complement C3 polymorphism on liver transplant patient and graft survival, subsequent evidence has been conflicting. Our aim was to clarify the contributions of donor and recipient C3 genotype, separately and together, on patient and graft outcomes and acute rejection incidence in liver transplant recipients. Eight donor/recipient groups were analyzed according to their genotype and presence or absence of C3 F allele (FFFS, FFSS, FSFF, FSFS, FSSS, SSFF, SSFS, and SSSS) and correlated with clinical outcomes of patient survival, graft survival, and rejection. The further impact of brain death vs. circulatory death during liver donation was also considered. Over a median 5.3 y follow-up of 506 patients with clinical information and matching donor and recipient tissue, five-year patient and graft survival (95% confidence interval) were 90(81-91)% and 77(73-85)%, respectively, and 72(69-94)% were rejection-free. Early disadvantages to patient survival were associated with donor C3 F variant, especially in brain-death donors. Recipient C3 genotype was an independent determinant of graft survival by Cox proportional hazards analysis (hazard ratio 0.26, P = 0.04), and the C3 F donor variant was again associated with worse liver graft survival, particularly in brain-death donors. C3 genotype did not independently determine rejection incidence, but a greater proportion of recipient C3 F carriers were rejection-free in the circulatory death, but not the brain-death cohort. Cox proportional hazards analysis revealed significant effects of acute rejection on patient survival (hazard ratio 0.24, P = 0.018), of retransplantation on rejection risk (hazard ratio 6.3, P = 0.009), and of donor type (circulatory-death vs. brain-death) on rejection incidence (hazard ratio 4.9, P = 0.005). We conclude that both donor and recipient complement C3 genotype may influence patient and graft outcomes after liver transplantation but that the type of liver donor is additionally influential, possibly via the inflammatory environment of the transplant.
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Delanghe JR, De Buyzere ML, Speeckaert MM. Genetic Polymorphisms in the Host and COVID-19 Infection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:109-118. [PMID: 33973175 DOI: 10.1007/978-3-030-63761-3_7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The outbreak of the COVID-19 pandemic shows a marked geographical variation in its prevalence and mortality. The question arises if the host genetic variation may (partly) affect the prevalence and mortality of COVID-19. We postulated that the geographical variation of human polymorphisms might partly explain the variable prevalence of the infection. We investigated some candidate genes that have the potential to play a role in the immune defense against COVID-19: complement component 3 (C3), galactoside 2-alpha-L-fucosyltransferase 2 (FUT2), haptoglobin (Hp), vitamin D binding protein (DBP), human homeostatic iron regulator protein (HFE), cystic fibrosis transmembrane conductance regulator (CFTR), and angiotensin-converting enzyme 1 (ACE1). In a univariate approach, ACE1 D/I, C3, CFTR, and HFE polymorphisms correlated significantly with COVID-19 prevalence/mortality, whereas Hp and FUT2 polymorphism did not show any significant correlations. In a multivariate analysis, only ACE1 D/I and C3 polymorphisms were determinants for COVID-19 prevalence/mortality. The other polymorphisms (CFTR, DBP, FUT2, HFE, and Hp) did not correlate with COVID-19 prevalence/mortality. Whereas ACE1 D/I polymorphism shows functional links with ACE2 (which is the receptor for the virus) in COVID-19, C3 can act as a critical step in the virus-induced inflammation. Our findings plead against a bystander role of the polymorphisms as a marker for historical migrations, which comigrate with causal genes involved in COVID-19 infection. Further studies are required to assess the clinical outcome of COVID-19 in C3S and ACE1 D allele carriers and to study the role of C3 and ACE1 D/I polymorphisms in COVID-19 and their potential effects on treatment response.
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Affiliation(s)
- Joris R Delanghe
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium. .,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Ghent, Belgium.
| | | | - Marijn M Speeckaert
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Research Foundation-Flanders (FWO), Ghent, Belgium
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Kardol-Hoefnagel T, Budding K, van de Graaf EA, van Setten J, van Rossum OA, Oudijk EJD, Otten HG. A Single Nucleotide C3 Polymorphism Associates With Clinical Outcome After Lung Transplantation. Front Immunol 2019; 10:2245. [PMID: 31616421 PMCID: PMC6775212 DOI: 10.3389/fimmu.2019.02245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/04/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Development of chronic rejection is still a severe problem and causes high mortality rates after lung transplantation (LTx). Complement activation is important in the development of acute rejection (AR) and bronchiolitis obliterans syndrome, with C3 as a key complement factor. Methods: We investigated a single nucleotide polymorphism (SNP) in the C3 gene (rs2230199) in relation to long-term outcome after LTx in 144 patient-donor pairs. In addition, we looked at local production of donor C3 by analyzing bronchoalveolar lavage fluid (BALF) of 6 LTx patients using isoelectric focusing (IEF). Results: We demonstrated the presence of C3 in BALF and showed that this is produced by the donor lung based on the genotype of SNP rs2230199. We also analyzed donor and patient SNP configurations and observed a significant association between the SNP configuration in patients and episodes of AR during 4-years follow-up. Survival analysis showed a lower AR-free survival in homozygous C3 slow patients (p = 0.005). Furthermore, we found a significant association between the SNP configuration in donors and BOS development. Patients receiving a graft from a donor with at least one C3 fast variant for rs2230199 had an inferior BOS-free survival (p = 0.044). Conclusions: In conclusion, our data indicate local C3 production by donor lung cells. In addition, a single C3 SNP present in recipients affects short-term outcome after LTx, while this SNP in donors has an opposite effect on long-term outcome after LTx. These results could contribute to an improved risk stratification after transplantation.
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Affiliation(s)
- Tineke Kardol-Hoefnagel
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Kevin Budding
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Eduard A van de Graaf
- Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jessica van Setten
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Oliver A van Rossum
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Erik-Jan D Oudijk
- Center of Interstitial Lung Diseases, St. Antonius Hospital, Nieuwegein, Netherlands
| | - Henderikus G Otten
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
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Hilhorst M, van Paassen P, van Rie H, Bijnens N, Heerings-Rewinkel P, van Breda Vriesman P, Cohen Tervaert JW. Complement in ANCA-associated glomerulonephritis. Nephrol Dial Transplant 2018; 32:1302-1313. [PMID: 26275893 DOI: 10.1093/ndt/gfv288] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 06/23/2015] [Indexed: 12/21/2022] Open
Abstract
Background Anti-neutrophil cytoplasmic antibodies (ANCA) are found in pauci-immune necrotizing crescentic glomerulonephritis. In the past, the role of complement in ANCA-associated vasculitis (AAV) was assumed to be minimal. More recently, however, it was found that blocking the complement cascade in a mouse model of AAV reduces glomerular damage. Immune complex deposits have been found in biopsies from AAV patients. In this study, we questioned whether immune complex formation or deposition may result in complement activation in ANCA-associated glomerulonephritis. Methods ANCA-positive patients from the Limburg Renal Registry were included between 1979 and 2011. Renal histology was documented together with immunoglobulin and complement immunofluorescence. In addition, C3d, properdin, C4d and mannose-binding lectin (MBL) were stained. Electron microscopy was performed. Circulating immune complexes were determined in a subset of patients, as well as C3 allotypes. Results C3c was found in 78 of 187 renal biopsies (41.7%) divided over 32.3% of proteinase-3 (PR3)-AAV patients and 52.3% of myeloperoxidase (MPO)-AAV patients (P = 0.006), whereas C3d was found positive in 51.1% of PR3-AAV patients and 70.4% of MPO-AAV patients (P = 0.105). C4d was found positive in 70.8%, properdin in 38.7% and MBL in 30.4% of patients. Whereas C4d and MBL positivity was similar between the AGN groups, properdin was more common in biopsies classified as crescentic compared with biopsies classified as focal or mixed. Renal biopsies positive for C3d and/or properdin showed more cellular crescents and less normal glomeruli compared with biopsies negative for C3d and/or properdin (P < 0.05). In 3 out of 43 renal biopsies analysed by electron microscopy, small electron dense deposits were found. In 14 of 46 patients analysed, circulating immune complexes were detectable. No association between histological findings and C3 allotypes was found. Conclusions In the majority of AAV patients, no immune complex deposits were found in their renal biopsies. C3d, C4d and C5b-9 staining, however, was found to be positive in a majority of analysed renal biopsies. Importantly, C3d and properdin staining was associated with cellular crescents. We hypothesize that local immune complexes are quickly degraded in AAV and therefore not visible by electron microscopy. Our findings are compatible with the hypothesis that complement activation in AAV occurs predominantly via alternative pathway activation.
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Affiliation(s)
- Marc Hilhorst
- Clinical & Experimental Immunology, Cardiovascular Research Centre Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Pieter van Paassen
- Clinical & Experimental Immunology, Cardiovascular Research Centre Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Nephrology, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Henk van Rie
- Clinical & Experimental Immunology, Cardiovascular Research Centre Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Pathology, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Nele Bijnens
- Clinical & Experimental Immunology, Cardiovascular Research Centre Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Pathology, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Petra Heerings-Rewinkel
- Clinical & Experimental Immunology, Cardiovascular Research Centre Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Peter van Breda Vriesman
- Clinical & Experimental Immunology, Cardiovascular Research Centre Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Jan Willem Cohen Tervaert
- Clinical & Experimental Immunology, Cardiovascular Research Centre Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
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Valero-Hervás DM, Sánchez-Zapardiel E, Castro MJ, Gallego-Bustos F, Cambra F, Justo I, Laguna-Goya R, Jiménez-Romero C, Moreno E, López-Medrano F, San Juan R, Fernández-Ruiz M, Aguado JM, Paz-Artal E. Complement C3F allotype synthesized by liver recipient modifies transplantation outcome independently from donor hepatic C3. Clin Transplant 2016; 31. [PMID: 27801525 DOI: 10.1111/ctr.12866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2016] [Indexed: 12/12/2022]
Abstract
Complement component 3 (C3) presents both slow (C3S) and fast (C3F) variants, which can be locally produced and activated by immune system cells. We studied C3 recipient variants in 483 liver transplant patients by RT-PCR-HRM to determine their effect on graft outcome during the first year post-transplantation. Allograft survival was significantly decreased in C3FF recipients (C3SS 95% vs C3FS 91% vs C3FF 83%; P=.01) or C3F allele carriers (C3F absence 95% vs C3F presence 90%, P=.02). C3FF genotype or presence of C3F allele independently increased risk for allograft loss (OR: 2.38, P=.005 and OR: 2.66, P=.02, respectively). C3FF genotype was more frequent among patients whose first infection was of viral etiology (C3SS 13% vs C3FS 18% vs C3FF 32%; P=.04) and independently increased risk for post-transplant viral infections (OR: 3.60, P=.008). On the other hand, C3FF and C3F protected from rejection events (OR: 0.54, P=.03 and OR: 0.63, P=.047, respectively). Differences were not observed in hepatitis C virus recurrence or patient survival. In conclusion, we show that, independently from C3 variants produced by donor liver, C3F variant from recipient diminishes allograft survival, increases susceptibility to viral infections, and protects from rejection after transplantation. C3 genotyping of liver recipients may be useful to stratify risk.
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Affiliation(s)
| | | | - María José Castro
- Department of Immunology, Hospital 12 de Octubre, Madrid, Spain.,I+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain
| | | | - Félix Cambra
- Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital 12 de Octubre, Madrid, Spain
| | - Iago Justo
- Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital 12 de Octubre, Madrid, Spain
| | - Rocío Laguna-Goya
- Department of Immunology, Hospital 12 de Octubre, Madrid, Spain.,I+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain
| | - Carlos Jiménez-Romero
- I+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital 12 de Octubre, Madrid, Spain.,School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Enrique Moreno
- I+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Department of General and Digestive Surgery and Abdominal Organ Transplantation, Hospital 12 de Octubre, Madrid, Spain.,School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Francisco López-Medrano
- I+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Unit of Infectious Diseases, Hospital 12 de Octubre, Madrid, Spain
| | - Rafael San Juan
- I+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Unit of Infectious Diseases, Hospital 12 de Octubre, Madrid, Spain
| | - Mario Fernández-Ruiz
- I+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Unit of Infectious Diseases, Hospital 12 de Octubre, Madrid, Spain
| | - José María Aguado
- I+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain.,School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Unit of Infectious Diseases, Hospital 12 de Octubre, Madrid, Spain
| | - Estela Paz-Artal
- Department of Immunology, Hospital 12 de Octubre, Madrid, Spain.,I+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain.,School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Section of Immunology, Universidad San Pablo CEU, Madrid, Spain
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7
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Valero-Hervás D, Morales P, Castro M, Varela P, Castillo-Rama M, Moreno E, Meneu J, Mora-Díaz S, Talayero P, Paz-Artal E. Complement C3 Genotyping of Slow and Fast Variants by Real Time PCR-High Resolution Melting. EUR J INFLAMM 2012. [DOI: 10.1177/1721727x1201000308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
“Slow” and “Fast” C3 complement variants (C3S and C3F) result from a g.304C>G polymorphism that changes arginine to glycine at position 102. C3 variants are associated with complement-mediated diseases and outcome in transplantation. In this work C3 genotyping is achieved by a Real Time PCR - High Resolution Melting (RT-PCR-HRM) optimized method. In an analysis of 49 subjects, 10.2% were C3FF, 36.7% were C3SF and 53.1% were C3SS. Allelic frequencies (70% for C3S and 30% for C3F) were in Hardy-Weinberg equilibrium and similar to those published previously. When comparing RT-PCR-HRM with the currently used Tetraprimer-Amplification Refractory Mutation System PCR (T-ARMS-PCR), coincidence was 93.8%. The procedure shown here includes a single primer pair and low DNA amount per reaction. Detection of C3 variants by RT-PCR-HRM is accurate, easy, fast and low cost, and it may be the method of choice for C3 genotyping.
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Affiliation(s)
- D.M. Valero-Hervás
- Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain
- Immunodeficiencies and Transplant Immunology, Institute for Research Hospital 12 de Octubre, Madrid, Spain
| | - P. Morales
- Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain
- Immunodeficiencies and Transplant Immunology, Institute for Research Hospital 12 de Octubre, Madrid, Spain
| | - M.J. Castro
- Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain
- Immunodeficiencies and Transplant Immunology, Institute for Research Hospital 12 de Octubre, Madrid, Spain
| | - P. Varela
- Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain
| | - M. Castillo-Rama
- Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain
| | - E. Moreno
- Digestive and Abdominal Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain
| | - J.C. Meneu
- Digestive and Abdominal Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain
| | - S. Mora-Díaz
- Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain
| | - P. Talayero
- Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain
- Immunodeficiencies and Transplant Immunology, Institute for Research Hospital 12 de Octubre, Madrid, Spain
| | - E. Paz-Artal
- Department of Immunology, University Hospital 12 de Octubre, Madrid, Spain
- Immunodeficiencies and Transplant Immunology, Institute for Research Hospital 12 de Octubre, Madrid, Spain
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Complement C3 gene polymorphism in renal transplantation (an Iranian experience). Gene 2012; 498:254-8. [DOI: 10.1016/j.gene.2012.01.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 12/17/2011] [Accepted: 01/21/2012] [Indexed: 11/22/2022]
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De Witte E, Speeckaert MM, Van De Moortel L, Lecocq E, Delanghe JR. Human complement factor 3 polymorphism determination by capillary electrophoresis of serum. Electrophoresis 2012; 33:440-4. [PMID: 22228414 DOI: 10.1002/elps.201100451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 09/15/2011] [Accepted: 09/15/2011] [Indexed: 11/08/2022]
Abstract
Variability of complement factor 3 (C3) mobility in serum protein electrophoresis was investigated. We found that the migration time of C3 can be reproducibly determined (beween-run CV=0.76%) using clinical capillary electrophoresis (CE) equipment (the Capillarys™ 2 system, Sebia). Moreover, we found a significant difference (p<0.001) in migration times of the major C3 phenotypes FF (fast-fast), FS (fast-slow) and SS (slow-slow). Glycosylation did not significantly affect test results. This is the first report on the migration time of C3 phenotypes on a clinical CE instrument. The presented method allows faster data than agarose-electrophoresis or genotyping. Moreover, reference ranges for serum C3 concentration depend on C3 phenotype, which allows a better tailored clinical interpretation of C3 concentrations.
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Affiliation(s)
- Evy De Witte
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium
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