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Kamido H, Yamamoto S, Yokoi H, Mizuno M, Yanagita M. A Case of C3 Nephritis With a Rare Variant of the CFHR5 Gene. Cureus 2024; 16:e55102. [PMID: 38558633 PMCID: PMC10978818 DOI: 10.7759/cureus.55102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
C3 nephropathy is a renal disease caused by the aberrant activation of the alternative complement pathway. The long-term renal prognosis of C3 nephropathy is generally poor, and elucidation of its pathogenesis is clinically important. Genetic abnormalities within complement genes, encompassing autoantibodies targeting complement components and complement factor H-related proteins (CFHRs), can lead to abnormal complement activation. CFHR5 is one of the best-known responsible genes for C3 nephritis. Moreover, the renal prognosis can vary depending on the specific type of genetic mutation. Here, we report the case of a young woman with C3 nephritis and a heterozygous rare variant, P453S, in CFHR5. The P453S variant, characterized by amino acid substitutions with a low allele frequency, was located in the region essential for CFHR5 protein function, and multiple in silico analyses were done suggesting the pathological significance of P453S. The renal function of our patient remains stable. The P453S variant might contribute to the suppression of the CFHR5 protein's function, resulting in gradual complement progression and a favorable renal prognosis.
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Affiliation(s)
- Hisashi Kamido
- Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, JPN
| | - Shinya Yamamoto
- Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, JPN
| | - Hideki Yokoi
- Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, JPN
| | | | - Motoko Yanagita
- Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, JPN
- Human Biology, World Premier International Research Center Initiative-Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto, JPN
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Liang KV, Ellis BK, Stokes MB, Smith RJ, Gu X, Gale DP. Hematuria and Proteinuria in a Patient With Recurrent Pulmonary Illnesses: A Quiz. Am J Kidney Dis 2022; 79:A13-A15. [DOI: 10.1053/j.ajkd.2021.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/30/2021] [Indexed: 11/11/2022]
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Dunne OM, Gao X, Nan R, Gor J, Adamson PJ, Gordon DL, Moulin M, Haertlein M, Forsyth VT, Perkins SJ. A Dimerization Site at SCR-17/18 in Factor H Clarifies a New Mechanism for Complement Regulatory Control. Front Immunol 2021; 11:601895. [PMID: 33552059 PMCID: PMC7859452 DOI: 10.3389/fimmu.2020.601895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/03/2020] [Indexed: 11/15/2022] Open
Abstract
Complement Factor H (CFH), with 20 short complement regulator (SCR) domains, regulates the alternative pathway of complement in part through the interaction of its C-terminal SCR-19 and SCR-20 domains with host cell-bound C3b and anionic oligosaccharides. In solution, CFH forms small amounts of oligomers, with one of its self-association sites being in the SCR-16/20 domains. In order to correlate CFH function with dimer formation and the occurrence of rare disease-associated variants in SCR-16/20, we identified the dimerization site in SCR-16/20. For this, we expressed, in Pichia pastoris, the five domains in SCR-16/20 and six fragments of this with one-three domains (SCR-19/20, SCR-18/20, SCR-17/18, SCR-16/18, SCR-17 and SCR-18). Size-exclusion chromatography suggested that SCR dimer formation occurred in several fragments. Dimer formation was clarified using analytical ultracentrifugation, where quantitative c(s) size distribution analyses showed that SCR-19/20 was monomeric, SCR-18/20 was slightly dimeric, SCR-16/20, SCR-16/18 and SCR-18 showed more dimer formation, and SCR-17 and SCR-17/18 were primarily dimeric with dissociation constants of ~5 µM. The combination of these results located the SCR-16/20 dimerization site at SCR-17 and SCR-18. X-ray solution scattering experiments and molecular modelling fits confirmed the dimer site to be at SCR-17/18, this dimer being a side-by-side association of the two domains. We propose that the self-association of CFH at SCR-17/18 enables higher concentrations of CFH to be achieved when SCR-19/20 are bound to host cell surfaces in order to protect these better during inflammation. Dimer formation at SCR-17/18 clarified the association of genetic variants throughout SCR-16/20 with renal disease.
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Affiliation(s)
- Orla M Dunne
- Division of Biosciences, Department of Structural and Molecular Biology, University College London, London, United Kingdom.,Life Sciences Group, Institut Laue Langevin, Grenoble, France
| | - Xin Gao
- Division of Biosciences, Department of Structural and Molecular Biology, University College London, London, United Kingdom.,Division of Medicine, University College London, London, United Kingdom
| | - Ruodan Nan
- Division of Biosciences, Department of Structural and Molecular Biology, University College London, London, United Kingdom
| | - Jayesh Gor
- Division of Biosciences, Department of Structural and Molecular Biology, University College London, London, United Kingdom
| | - Penelope J Adamson
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre and Flinders University, Bedford Park, SA, Australia
| | - David L Gordon
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre and Flinders University, Bedford Park, SA, Australia
| | - Martine Moulin
- Life Sciences Group, Institut Laue Langevin, Grenoble, France
| | | | - V Trevor Forsyth
- Life Sciences Group, Institut Laue Langevin, Grenoble, France.,Faculty of Natural Sciences, Keele University, Staffordshire, United Kingdom
| | - Stephen J Perkins
- Division of Biosciences, Department of Structural and Molecular Biology, University College London, London, United Kingdom
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