Inhibition of the alternative pathway of complement activation by a serum factor generated during transplant rejection

Characterization of a C3/C3b regulatory protein in normal human serum

A protein which alters the activity of C3 and C3b has been isolated from normal human serum by sequential column chromatography. In purified form, at normal serum concentration, this protein fixes to cell-bound C3b. It cannot bind to C3d. After fixation, it prevents the inactivation of C3b by beta 1H and C3bINA in both the classical and alternative pathway C5 convertases. Independent of this action, fixation to C3b also markedly enhances the subsequent activity of C5. At higher concentrations, however, this protein is capable of blocking the activation of C3 by both pathway C3 convertases. This material, therefore, appears to represent a potent means of regulating several critical aspects of the biologic activity of the complement system.

Recurrence of dense deposits in transplanted kidney: II. Serum complement and nephritic factor profiles

Dense deposit disease of the kidney is a rare form of chronic glomerulonephritis frequently associated with serum complement abnormalities (low C3 levels) and a circulating C3 convertase activator of the alternative pathway, the C3 nephritic factor (NF). Eleven patients with end-stage dense deposit disease underwent kidney transplantation. Of the 11, 7 had pretransplant low C3 and NF. In the posttransplant period, persisting low C3 levels were associated with persisting NF, although not quantitatively so. The original glomerular lesion recurred in the graft within 6 months in 9 of 11. Of these 9, 2 had no complement abnormalities either prior to or after transplantation. Pretransplant complement abnormalities were rapidly corrected in 4 of 7 patients whether or not recurrence of the original lesion occurred. Thus, serum complement profiles before and after transplantation are neither predictive nor indicative of recurrence.