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Corvillo F, Akinci B. An overview of lipodystrophy and the role of the complement system. Mol Immunol 2019; 112:223-232. [PMID: 31177059 DOI: 10.1016/j.molimm.2019.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 12/19/2022]
Abstract
The complement system is a major component of innate immunity playing essential roles in the destruction of pathogens, the clearance of apoptotic cells and immune complexes, the enhancement of phagocytosis, inflammation, and the modulation of adaptive immune responses. During the last decades, numerous studies have shown that the complement system has key functions in the biology of certain tissues. For example, complement contributes to normal brain and embryonic development and to the homeostasis of lipid metabolism. However, the complement system is subjected to the effective balance between activation-inactivation to maintain complement homeostasis and to prevent self-injury to cells or tissues. When this control is disrupted, serious pathologies eventually develop, such as C3 glomerulopathy, autoimmune conditions and infections. Another heterogeneous group of ultra-rare diseases in which complement abnormalities have been described are the lipodystrophy syndromes. These diseases are characterized by the loss of adipose tissue throughout the entire body or partially. Complement over-activation has been reported in most of the patients with acquired partial lipodystrophy (also called Barraquer-Simons Syndrome) and in some cases of the generalized variety of the disease (Lawrence Syndrome). Even so, the mechanism through which the complement system induces adipose tissue abnormalities remains unclear. This review focuses on describing the link between the complement system and certain forms of lipodystrophy. In addition, we present an overview regarding the clinical presentation, differential diagnosis, classification, and management of patients with lipodystrophy associated with complement abnormalities.
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Affiliation(s)
- F Corvillo
- Complement Research Group, La Paz University Hospital Research Institute (IdiPAZ), La Paz University Hospital, Madrid, Spain; Center for Biomedical Network Research on Rare Diseases (CIBERER U754), Madrid, Spain.
| | - B Akinci
- Division of Endocrinology, Department of Internal Medicine, Dokuz Eylul University, Izmir, Turkey; Brehm Center for Diabetes Research, Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan, 1000 Wall Street, Room 5313, Ann Arbor, MI, 48105, USA
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Corvillo F, Bravo García-Morato M, Nozal P, Garrido S, Tortajada A, Rodríguez de Córdoba S, López-Trascasa M. Serum properdin consumption as a biomarker of C5 convertase dysregulation in C3 glomerulopathy. Clin Exp Immunol 2016; 184:118-25. [PMID: 26660535 DOI: 10.1111/cei.12754] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 12/03/2015] [Accepted: 12/03/2015] [Indexed: 12/11/2022] Open
Abstract
Properdin (P) stabilizes the alternative pathway (AP) convertases, being the only known positive regulator of the complement system. In addition, P is a pattern recognition molecule able to initiate directly the AP on non-self surfaces. Although P deficiencies have long been known to be associated with Neisseria infections and P is often found deposited at sites of AP activation and tissue injury, the potential role of P in the pathogenesis of complement dysregulation-associated disorders has not been studied extensively. Serum P levels were measured in 49 patients with histological and clinical evidence of C3 glomerulopathy (C3G). Patients were divided into two groups according to the presence or absence of C3 nephritic factor (C3NeF), an autoantibody that stabilizes the AP C3 convertase. The presence of this autoantibody results in a significant reduction in circulating C3 (P < 0·001) and C5 levels (P < 0·05), but does not alter factor B, P and sC5b-9 levels. Interestingly, in our cohort, serum P levels were low in 17 of the 32 C3NeF-negative patients. This group exhibited significant reduction of C3 (P < 0·001) and C5 (P < 0·001) and increase of sC5b-9 (P < 0·001) plasma levels compared to the control group. Also, P consumption was correlated significantly with C3 (r = 0·798, P = 0·0001), C5 (r = 0·806, P < 0·0001), sC5b-9 (r = -0·683, P = 0·043) and a higher degree of proteinuria (r = -0·862, P = 0·013). These results illustrate further the heterogeneity among C3G patients and suggest that P serum levels could be a reliable clinical biomarker to identify patients with underlying surface AP C5 convertase dysregulation.
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Affiliation(s)
- F Corvillo
- Unidad de Inmunología, IdiPAZ, Hospital Universitario La Paz, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER U754), Madrid, Spain
| | | | - P Nozal
- Unidad de Inmunología, IdiPAZ, Hospital Universitario La Paz, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER U754), Madrid, Spain
| | - S Garrido
- Unidad de Inmunología, IdiPAZ, Hospital Universitario La Paz, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER U754), Madrid, Spain
| | - A Tortajada
- Centro De Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas, Madrid, Spain (CIB-CSIC), Centro de Investigación Biomédica en Red de Enfermedades Raras (CBERER U738), Madrid, Spain
| | - S Rodríguez de Córdoba
- Centro De Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas, Madrid, Spain (CIB-CSIC), Centro de Investigación Biomédica en Red de Enfermedades Raras (CBERER U738), Madrid, Spain
| | - M López-Trascasa
- Unidad de Inmunología, IdiPAZ, Hospital Universitario La Paz, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER U754), Madrid, Spain
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