Skip to main content
Top
Published in: memo - Magazine of European Medical Oncology 3/2018

01-09-2018 | review

Role of complement in the pathogenesis of thrombotic microangiopathies

Authors: Eszter Trojnár, Ágnes Szilágyi, Bálint Mikes, Dorottya Csuka, György Sinkovits, Prof. Zoltán Prohászka

Published in: memo - Magazine of European Medical Oncology | Issue 3/2018

Login to get access

Summary

Thrombotic microangiopathies (TMAs) are rare but life-threatening disorders characterized by microvascular hemolytic anemia and acute thrombocytopenia with or without organ damage. The term TMA covers various subgroups of diseases, the pathogenesis of which is briefly summarized in this review. As highlighted here, complement activation may represent an important amalgamating process in all of these conditions, since it is able to link together activation and damage of multiple involved cell types, such as endothelial cells, platelets, and neutrophils.
Literature
1.
go back to reference Warwicker P, et al. Genetic studies into inherited and sporadic hemolytic uremic syndrome. Kidney Int. 1998;53(4):836–44.CrossRefPubMed Warwicker P, et al. Genetic studies into inherited and sporadic hemolytic uremic syndrome. Kidney Int. 1998;53(4):836–44.CrossRefPubMed
2.
go back to reference Szarvas N, et al. Genetic analysis and functional characterization of novel mutations in a series of patients with atypical hemolytic uremic syndrome. Mol Immunol. 2016;71:10–22.CrossRefPubMed Szarvas N, et al. Genetic analysis and functional characterization of novel mutations in a series of patients with atypical hemolytic uremic syndrome. Mol Immunol. 2016;71:10–22.CrossRefPubMed
3.
go back to reference Caprioli J, et al. Genetics of HUS: the impact of MCP, CFH, and IF mutations on clinical presentation, response to treatment, and outcome. Blood. 2006;108(4):1267–79.CrossRefPubMedPubMedCentral Caprioli J, et al. Genetics of HUS: the impact of MCP, CFH, and IF mutations on clinical presentation, response to treatment, and outcome. Blood. 2006;108(4):1267–79.CrossRefPubMedPubMedCentral
4.
go back to reference Westra D, et al. Atypical hemolytic uremic syndrome and genetic aberrations in the complement factor H‑related 5 gene. J Hum Genet. 2012;57(7):459–64.CrossRefPubMedPubMedCentral Westra D, et al. Atypical hemolytic uremic syndrome and genetic aberrations in the complement factor H‑related 5 gene. J Hum Genet. 2012;57(7):459–64.CrossRefPubMedPubMedCentral
5.
go back to reference Jozsi M, et al. Factor H autoantibodies in atypical hemolytic uremic syndrome correlate with CFHR1/CFHR3 deficiency. Blood. 2008;111(3):1512–4.CrossRefPubMed Jozsi M, et al. Factor H autoantibodies in atypical hemolytic uremic syndrome correlate with CFHR1/CFHR3 deficiency. Blood. 2008;111(3):1512–4.CrossRefPubMed
7.
go back to reference Thurman JM, et al. Alternative pathway of complement in children with diarrhea-associated hemolytic uremic syndrome. Clin J Am Soc Nephrol. 2009;4(12):1920–4.CrossRefPubMedPubMedCentral Thurman JM, et al. Alternative pathway of complement in children with diarrhea-associated hemolytic uremic syndrome. Clin J Am Soc Nephrol. 2009;4(12):1920–4.CrossRefPubMedPubMedCentral
8.
go back to reference Stahl AL, Sartz L, Karpman D. Complement activation on platelet-leukocyte complexes and microparticles in enterohemorrhagic Escherichia coli-induced hemolytic uremic syndrome. Blood. 2011;117(20):5503–13.CrossRefPubMed Stahl AL, Sartz L, Karpman D. Complement activation on platelet-leukocyte complexes and microparticles in enterohemorrhagic Escherichia coli-induced hemolytic uremic syndrome. Blood. 2011;117(20):5503–13.CrossRefPubMed
9.
go back to reference Westra D, et al. Serological and genetic complement alterations in infection-induced and complement-mediated hemolytic uremic syndrome. Pediatr Nephrol. 2017;32(2):297–309.CrossRefPubMed Westra D, et al. Serological and genetic complement alterations in infection-induced and complement-mediated hemolytic uremic syndrome. Pediatr Nephrol. 2017;32(2):297–309.CrossRefPubMed
10.
go back to reference Orth D, et al. Shiga toxin activates complement and binds factor H: evidence for an active role of complement in hemolytic uremic syndrome. J Immunol. 2009;182(10):6394–400.CrossRefPubMed Orth D, et al. Shiga toxin activates complement and binds factor H: evidence for an active role of complement in hemolytic uremic syndrome. J Immunol. 2009;182(10):6394–400.CrossRefPubMed
11.
go back to reference Arvidsson I, et al. Shiga toxin-induced complement-mediated hemolysis and release of complement-coated red blood cell-derived microvesicles in hemolytic uremic syndrome. J Immunol. 2015;194(5):2309–18.CrossRefPubMed Arvidsson I, et al. Shiga toxin-induced complement-mediated hemolysis and release of complement-coated red blood cell-derived microvesicles in hemolytic uremic syndrome. J Immunol. 2015;194(5):2309–18.CrossRefPubMed
12.
go back to reference Morigi M, et al. Alternative pathway activation of complement by Shiga toxin promotes exuberant C3a formation that triggers microvascular thrombosis. J Immunol. 2011;187(1):172–80.CrossRefPubMed Morigi M, et al. Alternative pathway activation of complement by Shiga toxin promotes exuberant C3a formation that triggers microvascular thrombosis. J Immunol. 2011;187(1):172–80.CrossRefPubMed
13.
14.
go back to reference Bettoni S, et al. Interaction between multimeric von Willebrand factor and complement: a fresh look to the pathophysiology of microvascular thrombosis. J Immunol. 2017;199(3):1021–40.CrossRefPubMed Bettoni S, et al. Interaction between multimeric von Willebrand factor and complement: a fresh look to the pathophysiology of microvascular thrombosis. J Immunol. 2017;199(3):1021–40.CrossRefPubMed
15.
go back to reference Reti M, et al. Complement activation in thrombotic thrombocytopenic purpura. J Thromb Haemost. 2012;10(5):791–8.CrossRefPubMed Reti M, et al. Complement activation in thrombotic thrombocytopenic purpura. J Thromb Haemost. 2012;10(5):791–8.CrossRefPubMed
17.
go back to reference Mikes B, et al. Elevated plasma neutrophil elastase concentration is associated with disease activity in patients with thrombotic thrombocytopenic purpura. Thromb Res. 2014;133(4):616–21.CrossRefPubMed Mikes B, et al. Elevated plasma neutrophil elastase concentration is associated with disease activity in patients with thrombotic thrombocytopenic purpura. Thromb Res. 2014;133(4):616–21.CrossRefPubMed
18.
go back to reference Ruiz-Torres MP, et al. Complement activation: the missing link between ADAMTS-13 deficiency and microvascular thrombosis of thrombotic microangiopathies. Thromb Haemost. 2005;93(3):443–52.PubMedCrossRef Ruiz-Torres MP, et al. Complement activation: the missing link between ADAMTS-13 deficiency and microvascular thrombosis of thrombotic microangiopathies. Thromb Haemost. 2005;93(3):443–52.PubMedCrossRef
19.
go back to reference Jodele S, et al. Abnormalities in the alternative pathway of complement in children with hematopoietic stem cell transplant-associated thrombotic microangiopathy. Blood. 2013;122(12):2003–7.CrossRefPubMedPubMedCentral Jodele S, et al. Abnormalities in the alternative pathway of complement in children with hematopoietic stem cell transplant-associated thrombotic microangiopathy. Blood. 2013;122(12):2003–7.CrossRefPubMedPubMedCentral
20.
go back to reference Gloude NJ, et al. Circulating dsDNA, endothelial injury, and complement activation in thrombotic microangiopathy and GVHD. Blood. 2017;130(10):1259–66.CrossRefPubMedPubMedCentral Gloude NJ, et al. Circulating dsDNA, endothelial injury, and complement activation in thrombotic microangiopathy and GVHD. Blood. 2017;130(10):1259–66.CrossRefPubMedPubMedCentral
21.
go back to reference Yuen J, et al. NETosing neutrophils activate complement both on their own NETs and bacteria via alternative and non-alternative pathways. Front Immunol. 2016;7:137.CrossRefPubMedPubMedCentral Yuen J, et al. NETosing neutrophils activate complement both on their own NETs and bacteria via alternative and non-alternative pathways. Front Immunol. 2016;7:137.CrossRefPubMedPubMedCentral
22.
go back to reference Farkas P, et al. Complement activation, inflammation and relative ADAMTS13 deficiency in secondary thrombotic microangiopathies. Immunobiology. 2017;222(2):119–27.CrossRefPubMed Farkas P, et al. Complement activation, inflammation and relative ADAMTS13 deficiency in secondary thrombotic microangiopathies. Immunobiology. 2017;222(2):119–27.CrossRefPubMed
23.
go back to reference Cofiell R, et al. Eculizumab reduces complement activation, inflammation, endothelial damage, thrombosis, and renal injury markers in aHUS. Blood. 2015;125(21):3253–62.CrossRefPubMedPubMedCentral Cofiell R, et al. Eculizumab reduces complement activation, inflammation, endothelial damage, thrombosis, and renal injury markers in aHUS. Blood. 2015;125(21):3253–62.CrossRefPubMedPubMedCentral
24.
go back to reference Azukaitis K, et al. The phenotypic spectrum of nephropathies associated with mutations in diacylglycerol kinase epsilon. J Am Soc Nephrol. 2017;28(10):3066–75.CrossRefPubMedPubMedCentral Azukaitis K, et al. The phenotypic spectrum of nephropathies associated with mutations in diacylglycerol kinase epsilon. J Am Soc Nephrol. 2017;28(10):3066–75.CrossRefPubMedPubMedCentral
26.
go back to reference Leffler J, et al. Decreased neutrophil extracellular trap degradation in Shiga toxin-associated haemolytic uraemic syndrome. J Innate Immun. 2017;9(1):12–21.CrossRefPubMed Leffler J, et al. Decreased neutrophil extracellular trap degradation in Shiga toxin-associated haemolytic uraemic syndrome. J Innate Immun. 2017;9(1):12–21.CrossRefPubMed
27.
go back to reference Lukasz A, et al. Serum neutrophil gelatinase-associated lipocalin (NGAL) in patients with Shiga toxin mediated haemolytic uraemic syndrome (STEC-HUS). Thromb Haemost. 2014;111(2):365–72.CrossRefPubMed Lukasz A, et al. Serum neutrophil gelatinase-associated lipocalin (NGAL) in patients with Shiga toxin mediated haemolytic uraemic syndrome (STEC-HUS). Thromb Haemost. 2014;111(2):365–72.CrossRefPubMed
28.
go back to reference Huang DT, et al. T‑antigen activation for prediction of pneumococcus-induced hemolytic uremic syndrome and hemolytic anemia. Pediatr Infect Dis J. 2006;25(7):608–10.CrossRefPubMed Huang DT, et al. T‑antigen activation for prediction of pneumococcus-induced hemolytic uremic syndrome and hemolytic anemia. Pediatr Infect Dis J. 2006;25(7):608–10.CrossRefPubMed
29.
go back to reference Szilagyi A, et al. The use of a rapid fluorogenic neuraminidase assay to differentiate acute streptococcus pneumoniae-associated hemolytic uremic syndrome (HUS) from other forms of HUS. Clin Chem Lab Med. 2015;53(4):e117–e9.CrossRefPubMed Szilagyi A, et al. The use of a rapid fluorogenic neuraminidase assay to differentiate acute streptococcus pneumoniae-associated hemolytic uremic syndrome (HUS) from other forms of HUS. Clin Chem Lab Med. 2015;53(4):e117–e9.CrossRefPubMed
30.
go back to reference Mikes B, et al. Carboxiterminal pro-endothelin-1 as an endothelial cell biomarker in thrombotic thrombocytopenic purpura. Thromb Haemost. 2016;115(5):1034–43.CrossRefPubMed Mikes B, et al. Carboxiterminal pro-endothelin-1 as an endothelial cell biomarker in thrombotic thrombocytopenic purpura. Thromb Haemost. 2016;115(5):1034–43.CrossRefPubMed
31.
go back to reference Bettoni G, et al. ADAMTS-13 activity and autoantibodies classes and subclasses as prognostic predictors in acquired thrombotic thrombocytopenic purpura. J Thromb Haemost. 2012;10(8):1556–65.CrossRefPubMed Bettoni G, et al. ADAMTS-13 activity and autoantibodies classes and subclasses as prognostic predictors in acquired thrombotic thrombocytopenic purpura. J Thromb Haemost. 2012;10(8):1556–65.CrossRefPubMed
Metadata
Title
Role of complement in the pathogenesis of thrombotic microangiopathies
Authors
Eszter Trojnár
Ágnes Szilágyi
Bálint Mikes
Dorottya Csuka
György Sinkovits
Prof. Zoltán Prohászka
Publication date
01-09-2018
Publisher
Springer Vienna
Published in
memo - Magazine of European Medical Oncology / Issue 3/2018
Print ISSN: 1865-5041
Electronic ISSN: 1865-5076
DOI
https://doi.org/10.1007/s12254-017-0380-y

Other articles of this Issue 3/2018

memo - Magazine of European Medical Oncology 3/2018 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine