1
|
Jiang J, Wang H, Liu K, He S, Li Z, Yuan Y, Yu K, Long P, Wang J, Diao T, Zhang X, He M, Guo H, Wu T. Association of Complement C3 With Incident Type 2 Diabetes and the Mediating Role of BMI: A 10-Year Follow-Up Study. J Clin Endocrinol Metab 2023; 108:736-744. [PMID: 36205019 DOI: 10.1210/clinem/dgac586] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 10/01/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Impairment of immune and inflammatory homeostasis is reported to be one of the causal factors of diabetes. However, the association of complement C3 levels with incident diabetes in humans remains unclear. OBJECTIVE This study aimed to examine the association between C3 levels and incident type 2 diabetes mellitus (T2DM), and further explore the potential mediating role of body mass index (BMI) in C3-T2DM associations. METHODS We determined serum C3 levels of 2662 nondiabetic middle-aged and elderly (64.62 ± 7.25 years) individuals from the Dongfeng-Tongji cohort at baseline. Cox regression was employed to examine the incidence of T2DM in relationship to C3 levels during 10 years of follow-up. Mediation analysis was further applied to assess potential effect of BMI on the C3-T2DM associations. RESULTS Overall, 711 (26.7%) participants developed T2DM during 23 067 person-years of follow-up. Higher serum C3 was significantly associated with higher risk of incident T2DM after full adjustment (HR [95% CI] = 1.16 [1.05, 1.27]; per SD higher). Compared with the first quartile of C3 levels, the HR in the fourth quartile was 1.52 (95% CI = [1.14, 2.02]; Ptrend = 0.029). Robust significant linear dose-response relationship was observed between C3 levels and BMI (Poverall < 0.001, Pnonlinear = 0.96). Mediation analyses indicated that BMI might mediate 41.0% of the associations between C3 and T2DM. CONCLUSION The present prospective study revealed that C3 could be an early biomarker for incident T2DM, and that BMI might play a potential mediating role in the C3-T2DM associations, which provided clues for the pathogenesis of diabetes.
Collapse
Affiliation(s)
- Jing Jiang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Hao Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Kang Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | - Shiqi He
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhaoyang Li
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yu Yuan
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Kuai Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Pinpin Long
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jing Wang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Tingyue Diao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Meian He
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Huan Guo
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| |
Collapse
|
2
|
Martin N, Tu X, Egan AJ, Stover C. Complement Activation on Endothelial Cell-Derived Microparticles-A Key Determinant for Cardiovascular Risk in Patients with Systemic Lupus Erythematosus? ACTA ACUST UNITED AC 2020; 56:E533. [PMID: 33065972 DOI: 10.3390/medicina56100533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 11/17/2022]
Abstract
Systemic lupus erythematosus is a classical systemic autoimmune disease that overactivates complement and can affect all organs. Early diagnosis and effective management are important in this immune-complex-mediated chronic inflammatory disease, which has a strong component of vasculitis and carries an increased risk of thrombosis, even in the absence of antiphospholipid antibodies. Development of lupus nephritis can be life limiting but is managed with dialysis and renal transplantation. Therefore, data have become available that cardiovascular risk poses a serious feature of systemic lupus erythematosus that requires monitoring and prospective treatment. Cell-derived microparticles circulate in plasma and thereby intersect the humoral and cellular component of inflammation. They are involved in disease pathophysiology, particularly thrombosis, and represent a known cardiovascular risk. This viewpoint argues that a focus on characteristics of circulating microparticles measured in patients with systemic lupus erythematosus may help to classify certain ethnic groups who are especially at additional risk of experiencing cardiovascular complications.
Collapse
|
3
|
Heesterbeek TJ, Lechanteur YTE, Lorés-Motta L, Schick T, Daha MR, Altay L, Liakopoulos S, Smailhodzic D, den Hollander AI, Hoyng CB, de Jong EK, Klevering BJ. Complement Activation Levels Are Related to Disease Stage in AMD. Invest Ophthalmol Vis Sci 2020; 61:18. [PMID: 32176267 PMCID: PMC7401663 DOI: 10.1167/iovs.61.3.18] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To study the levels of complement activation in different disease stages of AMD and the influence of genetic polymorphisms in complement genes. Methods We included 797 patients with AMD and 945 controls from the European Genetic Database. Patients were grouped into five AMD stages: early AMD, intermediate AMD, central geographic atrophy, active choroidal neovascularization or inactive choroidal neovascularization. Differences in complement activation, as defined by the systemic C3d/C3 ratio, between AMD stages were evaluated using general linear modeling. In addition, we evaluated the influence of 18 genetic AMD polymorphisms in complement genes and their effect on complement activation. Differences in complement activation between stages were evaluated stratifying by complement associated haplotypes. Results Complement activation levels differed significantly between AMD disease stages. As compared with controls, the C3d/C3 ratio was higher in patients with intermediate AMD (P < 0.001) and central geographic atrophy (P = 0.001). Two polymorphisms in CFH (rs10922109 and rs570618) and one in CFB (rs116503776) were significantly associated with complement activation. The association between AMD disease stage and complement activation was more pronounced in patients with haplotypes associated with the highest complement activation. Conclusions In general, consecutive AMD disease stages showed increasing levels of complement activation, especially in individuals with a genetic burden in complement genes. These findings contribute to the discussion on the pathogenesis of AMD in relation to complement activation and might suggest refinement in patient selection and the optimum window of treatment with complement inhibitors. Prospective studies are needed to confirm these results.
Collapse
|
4
|
Zitur LJ, Chlebeck PJ, Odorico SK, Danobeitia JS, Zens TJ, Van Kooten C, Eerhart M, Reyes JA, Springer ML, Coonen JM, Brunner KG, Capuano SV, D'Alessandro AM, Fernandez LA. Brain Death Enhances Activation of the Innate Immune System and Leads to Reduced Renal Metabolic Gene Expression. Transplantation 2019; 103:1821-33. [PMID: 30964836 DOI: 10.1097/TP.0000000000002744] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Brain death (BD)-associated inflammation has been implicated in decreased kidney allograft function and survival, but the underlying mechanisms have not been well distinguished from the conditions of critical care itself. We have developed a clinically translatable model to separate and investigate strategies to improve donor management and critical care. METHODS Brain-dead (n = 12) and sham (n = 5) rhesus macaques were maintained for 20 hours under intensive care unit-level conditions. Samples were collected for immunophenotyping, analysis of plasma proteins, coagulation studies, and gene analysis for changes in immune and metabolic profile with comparison to naive samples (n = 10). RESULTS We observed an increase in circulating leukocytes and cytokines, activation of complement and coagulation pathways, and upregulation of genes associated with inflammation in both brain-dead and sham subjects relative to naïve controls. Sham demonstrated an intermediate phenotype of inflammation compared to BD. Analysis of gene expression in kidneys from BD kidneys revealed a similar upregulation of inflammatory profile in both BD and sham subjects, but BD presented a distinct reduction in metabolic and respiratory processes compared to sham and naïve kidneys. CONCLUSION BD is associated with activation of specific pathways of the innate immune system and changes to metabolic gene expression in renal tissue itself; however, sham donors presented an intermediate inflammatory response attributable to the critical care environment. The early onset and penetrating impact of this inflammatory response underscores the need for early intervention to prevent perioperative tissue injury to transplantable organs.
Collapse
|
5
|
Borné Y, Muhammad IF, Lorés-Motta L, Hedblad B, Nilsson PM, Melander O, de Jong EK, Blom AM, den Hollander AI, Engström G. Complement C3 Associates With Incidence of Diabetes, but No Evidence of a Causal Relationship. J Clin Endocrinol Metab 2017; 102:4477-4485. [PMID: 29029276 DOI: 10.1210/jc.2017-00948] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 09/26/2017] [Indexed: 01/03/2023]
Abstract
PURPOSE This study explored whether complement factor 3 (C3) in plasma is associated with incidence of diabetes in a population-based cohort. We also identified genetic variants related to C3 and explored whether C3 and diabetes share common genetic determinants. METHODS C3 was analyzed in plasma from 4368 nondiabetic subjects, 46 to 68 years old, from the Malmö Diet and Cancer Study. Incidence of diabetes was studied in relationship to C3 levels during 17.7± 4.4 years of follow-up. Genotypes associated with C3 were identified in a genome-wide association study. Diabetes Genetics Replication and Meta-Analysis and the European Genetic Database were used for in silico look-up. RESULTS In all, 538 (12.3%) subjects developed diabetes during 18 years of follow-up. High C3 was significantly associated with incidence of diabetes after risk factor adjustments (hazard ratio comparing 4th vs 1st quartile, 1.54 (95% confidence interval, 1.13 to 2.09; P = 0.005). C3 was associated with polymorphisms at the complement factor H locus (P < 10-8). However, no relationship with diabetes was observed for this locus. Another eight loci were associated with C3 with P < 10-5. One of them, the glucose kinase regulatory protein (GCKR) locus, has been previously associated with diabetes. The relationship between C3 levels and the GCKR locus was replicated in the European Genetic Database cohort. CONCLUSIONS Plasma concentration of C3 is a risk marker for incidence of diabetes. The results suggest that this association could, in part, be explained by pleiotropic effects related to the GCKR gene.
Collapse
Affiliation(s)
- Yan Borné
- Department of Clinical Sciences, Lund University, Sweden
| | | | - Laura Lorés-Motta
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, The Netherlands
| | - Bo Hedblad
- Department of Clinical Sciences, Lund University, Sweden
| | | | - Olle Melander
- Department of Clinical Sciences, Lund University, Sweden
| | - Eiko K de Jong
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, The Netherlands
| | - Anna M Blom
- Department of Translational Medicine, Lund University, Sweden
| | - Anneke I den Hollander
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, The Netherlands
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, The Netherlands
| | | |
Collapse
|
6
|
Geragotou T, Jainandunsing S, Özcan B, de Rooij FWM, Kokkinos A, Tentolouris N, Sijbrands EJG. The Relationship of Metabolic Syndrome Traits with Beta-Cell Function and Insulin Sensitivity by Oral Minimal Model Assessment in South Asian and European Families Residing in the Netherlands. J Diabetes Res 2016; 2016:9286303. [PMID: 27597980 PMCID: PMC4997024 DOI: 10.1155/2016/9286303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/12/2016] [Indexed: 11/17/2022] Open
Abstract
Background. There are different metabolic syndrome traits among patients with different ethnicities. Methods. We investigated this by studying 44 South Asians and 54 Europeans and classified them in three groups according to the occurrence of metabolic syndrome (MetS) and Type 2 Diabetes (T2D). Insulin sensitivity index (ISI), static, dynamic, and total beta-cell responsivity indices (Φ), and disposition indices (DIs) were calculated with the use of oral minimal model (OMM). Results. In both ethnicities, ISI was lower in the subgroup with MetS and T2D as compared to the subgroup without MetS nor T2D (P < 0.004). South Asians without MetS were more insulin resistant than Europeans without MetS (P = 0.033). In the South Asians, ISI, dynamic DI, and static DI were associated significantly (P < 0.006) with high-density lipoprotein cholesterol and triglycerides. In the Europeans, ISI was associated with waist-to-hip ratio (P = 0.005) and systolic and diastolic blood pressure (P < 0.005), while static DI was related to the systolic blood pressure (P = 0.005). Conclusions. MetS was linked with insulin resistance and reduced capacity to handle glucose regardless of ethnicity. ISI and DIs were associated with lipid traits in South Asians and with blood pressure in Europeans suggesting that insulin resistance enhances different metabolic syndrome traits among different ethnicities.
Collapse
Affiliation(s)
- Thekla Geragotou
- Department of Internal Medicine, Erasmus MC-University Medical Center Rotterdam, 3015 CE Rotterdam, Netherlands
- First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian of Athens, Laiko General Hospital, 11527 Athens, Greece
- *Thekla Geragotou:
| | - Sjaam Jainandunsing
- Department of Internal Medicine, Erasmus MC-University Medical Center Rotterdam, 3015 CE Rotterdam, Netherlands
| | - Behiye Özcan
- Department of Internal Medicine, Erasmus MC-University Medical Center Rotterdam, 3015 CE Rotterdam, Netherlands
| | - Felix W. M. de Rooij
- Department of Internal Medicine, Erasmus MC-University Medical Center Rotterdam, 3015 CE Rotterdam, Netherlands
| | - Alexander Kokkinos
- Department of Internal Medicine, Erasmus MC-University Medical Center Rotterdam, 3015 CE Rotterdam, Netherlands
| | - Nicholas Tentolouris
- First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian of Athens, Laiko General Hospital, 11527 Athens, Greece
| | - Eric J. G. Sijbrands
- Department of Internal Medicine, Erasmus MC-University Medical Center Rotterdam, 3015 CE Rotterdam, Netherlands
| |
Collapse
|
7
|
Gijsberts CM, den Ruijter HM, Asselbergs FW, Chan MY, de Kleijn DPV, Hoefer IE. Biomarkers of Coronary Artery Disease Differ Between Asians and Caucasians in the General Population. Glob Heart 2015; 10:301-311.e11. [PMID: 26014657 DOI: 10.1016/j.gheart.2014.11.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/10/2014] [Accepted: 11/17/2014] [Indexed: 11/29/2022] Open
Abstract
Coronary artery disease (CAD) markers have not been thoroughly investigated among Asians. The incidence of CAD, however, is rising rapidly in Asia. In this review, we systematically discuss publications that compare CAD biomarkers between Asians and Caucasians in the general population. A PubMed search yielded 5,570 hits, containing 59 articles describing 47 unique cohorts that directly compare Asians with Caucasians. Ten biomarkers were taken into account for this review: total cholesterol; triglycerides; high-density lipoprotein cholesterol; low-density lipoprotein cholesterol; C-reactive protein; glucose; insulin; glycated hemoglobin; fibrinogen; and plasminogen activator inhibitor-1. Triglycerides were 1.13-fold higher in South Asians than in Caucasians, and insulin levels were 1.33-fold higher. In Japanese and Chinese subjects, lower C-reactive protein levels were reported: 0.52 and 0.36-fold, respectively. Ethnicity-specific prognostic measures of CAD biomarkers were rarely reported. CAD biomarker levels differ between Asians and Caucasians and among Asian ethnic groups in population-based cohorts. The ethnicity-specific prognostic value of CAD biomarkers is yet to be determined.
Collapse
Affiliation(s)
- Crystel M Gijsberts
- Laboratory of Experimental Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands; ICIN-Netherlands Heart Institute, Utrecht, the Netherlands.
| | - Hester M den Ruijter
- Laboratory of Experimental Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Folkert W Asselbergs
- Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, the Netherlands; Institute of Cardiovascular Science, Population Health Sciences, University College London, London, United Kingdom
| | - Mark Y Chan
- Department of Cardiology, National University Singapore, Singapore; Cardiovascular Research Institute, National University Heart Centre Singapore, National University Health System, Singapore
| | - Dominique P V de Kleijn
- Laboratory of Experimental Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands; Cardiovascular Research Institute, National University Heart Centre Singapore, National University Health System, Singapore; Department of Surgery, National University Singapore, Singapore
| | - Imo E Hoefer
- Laboratory of Experimental Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| |
Collapse
|
8
|
Le BBS, Tillou X, Branchereau J, Dilek N, Poirier N, Châtelais M, Charreau B, Minault D, Hervouet J, Renaudin K, Crossan C, Scobie L, Takeuchi Y, Diswall M, Breimer M, Klar N, Daha M, Simioni P, Robson S, Nottle M, Salvaris E, Cowan P, d’Apice A, Sachs D, Yamada K, Lagutina I, Duchi R, Perota A, Lazzari G, Galli C, Cozzi E, Soulillou JP, B. V, Blancho G. Bortezomib, C1-inhibitor and plasma exchange do not prolong the survival of multi-transgenic GalT-KO pig kidney xenografts in baboons. Am J Transplant 2015; 15:358-70. [PMID: 25612490 PMCID: PMC4306235 DOI: 10.1111/ajt.12988] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 04/15/2014] [Revised: 07/23/2014] [Accepted: 08/12/2014] [Indexed: 01/25/2023]
Abstract
Galactosyl-transferase KO (GalT-KO) pigs represent a potential solution to xenograft rejection, particularly in the context of additional genetic modifications. We have performed life supporting kidney xenotransplantation into baboons utilizing GalT-KO pigs transgenic for human CD55/CD59/CD39/HT. Baboons received tacrolimus, mycophenolate mofetil, corticosteroids and recombinant human C1 inhibitor combined with cyclophosphamide or bortezomib with or without 2-3 plasma exchanges. One baboon received a control GalT-KO xenograft with the latter immunosuppression. All immunosuppressed baboons rejected the xenografts between days 9 and 15 with signs of acute humoral rejection, in contrast to untreated controls (n = 2) that lost their grafts on days 3 and 4. Immunofluorescence analyses showed deposition of IgM, C3, C5b-9 in rejected grafts, without C4d staining, indicating classical complement pathway blockade but alternate pathway activation. Moreover, rejected organs exhibited predominantly monocyte/macrophage infiltration with minimal lymphocyte representation. None of the recipients showed any signs of porcine endogenous retrovirus transmission but some showed evidence of porcine cytomegalovirus (PCMV) replication within the xenografts. Our work indicates that the addition of bortezomib and plasma exchange to the immunosuppressive regimen did not significantly prolong the survival of multi-transgenic GalT-KO renal xenografts. Non-Gal antibodies, the alternative complement pathway, innate mechanisms with monocyte activation and PCMV replication may have contributed to rejection.
Collapse
Affiliation(s)
- Bas-Bernardet S. Le
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - X. Tillou
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France
| | - J. Branchereau
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France
| | - N. Dilek
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Effimune, Nantes, France
| | - N. Poirier
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Effimune, Nantes, France
| | - M. Châtelais
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - B. Charreau
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - D. Minault
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France
| | - J. Hervouet
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France
| | - K. Renaudin
- Pathology Laboratory, CHU- Hôtel Dieu, Nantes, France
| | - C. Crossan
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, United Kingdom,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - L. Scobie
- Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, United Kingdom,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - Y. Takeuchi
- University College London, London, United Kingdom,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - M. Diswall
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - M.E. Breimer
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - N. Klar
- Department of Nephrology, University Medical Center, Leiden, The Netherlands,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - M.R. Daha
- Department of Nephrology, University Medical Center, Leiden, The Netherlands,Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy
| | - P. Simioni
- Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Padua, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - S.C. Robson
- Gastroenterology and Transplant Institute, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - M.B. Nottle
- Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
| | - E.J. Salvaris
- Immunology Research Centre, St Vincent’s Hospital Melbourne, Victoria, Australia
| | - P.J. Cowan
- Immunology Research Centre, St Vincent’s Hospital Melbourne, Victoria, Australia
| | - A.J.F. d’Apice
- Immunology Research Centre, St Vincent’s Hospital Melbourne, Victoria, Australia
| | - D.H. Sachs
- Transplantation Biology Research Center (TBRC), Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA
| | - K. Yamada
- Transplantation Biology Research Center (TBRC), Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA
| | - I. Lagutina
- Avantea, Cremona, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - R. Duchi
- Avantea, Cremona, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - A. Perota
- Avantea, Cremona, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - G. Lazzari
- Avantea, Cremona, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - C. Galli
- Avantea, Cremona, Italy,Dept. of Veterinary Medical Science, University of Bologna, Ozzano Emilia, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - E. Cozzi
- Transplant Immunology Unit, Padua General Hospital, Padua, Italy and Consortium for Research in Organ Transplantation (CORIT), Padua, Italy,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - J.-P. Soulillou
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| | - Vanhove B.
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,Effimune, Nantes, France
| | - G. Blancho
- Institut de Transplantation- Urologie- Néphrologie (ITUN), Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1064, Centre Hospitalier Universitaire (CHU) de Nantes, Université de Nantes, Nantes, France,European Xenotransplantation Network Xenome (LSHB- CT- 2006- 037377)
| |
Collapse
|
9
|
Smailhodzic D, van Asten F, Blom AM, Mohlin FC, den Hollander AI, van de Ven JP, van Huet RA, Groenewoud JM, Tian Y, Berendschot TT, Lechanteur YT, Fauser S, de Bruijn C, Daha MR, van der Wilt GJ, Hoyng CB, Klevering BJ. Zinc supplementation inhibits complement activation in age-related macular degeneration. PLoS One 2014; 9:e112682. [PMID: 25393287 DOI: 10.1371/journal.pone.0112682] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 10/06/2014] [Indexed: 11/19/2022] Open
Abstract
Age-related macular degeneration (AMD) is the leading cause of blindness in the Western world. AMD is a multifactorial disorder but complement-mediated inflammation at the level of the retina plays a pivotal role. Oral zinc supplementation can reduce the progression of AMD but the precise mechanism of this protective effect is as yet unclear. We investigated whether zinc supplementation directly affects the degree of complement activation in AMD and whether there is a relation between serum complement catabolism during zinc administration and the complement factor H (CFH) gene or the Age-Related Maculopathy susceptibility 2 (ARMS2) genotype. In this open-label clinical study, 72 randomly selected AMD patients in various stages of AMD received a daily supplement of 50 mg zinc sulphate and 1 mg cupric sulphate for three months. Serum complement catabolism–defined as the C3d/C3 ratio–was measured at baseline, throughout the three months of supplementation and after discontinuation of zinc administration. Additionally, downstream inhibition of complement catabolism was evaluated by measurement of anaphylatoxin C5a. Furthermore, we investigated the effect of zinc on complement activation in vitro. AMD patients with high levels of complement catabolism at baseline exhibited a steeper decline in serum complement activation (p<0.001) during the three month zinc supplementation period compared to patients with low complement levels. There was no significant association of change in complement catabolism and CFH and ARMS2 genotype. In vitro zinc sulphate directly inhibits complement catabolism in hemolytic assays and membrane attack complex (MAC) deposition on RPE cells. This study provides evidence that daily administration of 50 mg zinc sulphate can inhibit complement catabolism in AMD patients with increased complement activation. This could explain part of the mechanism by which zinc slows AMD progression. Trial Registration The Netherlands National Trial Register NTR2605
Collapse
|
10
|
Hertle E, Stehouwer CD, van Greevenbroek MM. The complement system in human cardiometabolic disease. Mol Immunol 2014; 61:135-48. [PMID: 25017306 DOI: 10.1016/j.molimm.2014.06.031] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 06/18/2014] [Accepted: 06/23/2014] [Indexed: 02/07/2023]
Abstract
The complement system has been implicated in obesity, fatty liver, diabetes and cardiovascular disease (CVD). Complement factors are produced in adipose tissue and appear to be involved in adipose tissue metabolism and local inflammation. Thereby complement links adipose tissue inflammation to systemic metabolic derangements, such as low-grade inflammation, insulin resistance and dyslipidaemia. Furthermore, complement has been implicated in pathophysiological mechanisms of diet- and alcohol induced liver damage, hyperglycaemia, endothelial dysfunction, atherosclerosis and fibrinolysis. In this review, we summarize current evidence on the role of the complement system in several processes of human cardiometabolic disease. C3 is the central component in complement activation, and has most widely been studied in humans. C3 concentrations are associated with insulin resistance, liver dysfunction, risk of the metabolic syndrome, type 2 diabetes and CVD. C3 can be activated by the classical, the lectin and the alternative pathway of complement activation; and downstream activation of C3 activates the terminal pathway. Complement may also be activated via extrinsic proteases of the coagulation, fibrinolysis and the kinin systems. Studies on the different complement activation pathways in human cardiometabolic disease are limited, but available evidence suggests that they may have distinct roles in processes underlying cardiometabolic disease. The lectin pathway appeared beneficial in some studies on type 2 diabetes and CVD, while factors of the classical and the alternative pathway were related to unfavourable cardiometabolic traits. The terminal complement pathway was also implicated in insulin resistance and liver disease, and appears to have a prominent role in acute and advanced CVD. The available human data suggest a complex and potentially causal role for the complement system in human cardiometabolic disease. Further, preferably longitudinal studies are needed to disentangle which aspects of the complement system and complement activation affect the different processes in human cardiometabolic disease.
Collapse
|
11
|
Somani R, Richardson VR, Standeven KF, Grant PJ, Carter AM. Elevated properdin and enhanced complement activation in first-degree relatives of South Asian subjects with type 2 diabetes. Diabetes Care 2012; 35:894-9. [PMID: 22338105 PMCID: PMC3308267 DOI: 10.2337/dc11-1483] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Emerging data implicate activation of the complement cascade in the pathogenesis of type 2 diabetes. The objective of the current study was to evaluate the relationships between components of the complement system, metabolic risk factors, and family history of type 2 diabetes in healthy South Asians. RESEARCH DESIGN AND METHODS We recruited 119 healthy, first-degree relatives of South Asian subjects with type 2 diabetes (SARs) and 119 age- and sex-matched, healthy South Asian control subjects (SACs). Fasting blood samples were taken for measurement of complement factors and standard metabolic risk factors. RESULTS SARs were characterized by significantly higher properdin (mean concentration 12.6 [95% CI 12.2-13.1] mg/L vs. SACs 10.1 [9.7-10.5] mg/L, P < 0.0001), factor B (187.4 [180.1-195.0] mg/L vs. SACs 165.0 [158.0-172.2] mg/L, P < 0.0001), and SC5b-9 (92.0 [86.1-98.3] ng/mL vs. SACs 75.3 [71.9-78.9] ng/mL, P < 0.0001) and increased homeostasis model assessment of insulin resistance (2.86 [2.61-3.13] vs. SACs 2.31 [2.05-2.61], P = 0.007). C-reactive protein did not differ between SARs and SACs (P = 0.17). In subgroup analysis of 25 SARs and 25 SACs with normal oral glucose tolerance tests, properdin, factor B, and SC5b-9 remained significantly elevated in SARs. CONCLUSIONS Increased properdin and complement activation are associated with a family history of type 2 diabetes in South Asians independent of insulin resistance, and predate the development of impaired fasting glucose and impaired glucose tolerance. Properdin and SC5b-9 may be novel biomarkers for future risk of type 2 diabetes in this high-risk population and warrant further investigation.
Collapse
Affiliation(s)
- Riyaz Somani
- Division of Cardiovascular and Diabetes Research, University of Leeds, Leeds, UK
| | | | | | | | | |
Collapse
|
12
|
Smailhodzic D, Klaver CC, Klevering BJ, Boon CJ, Groenewoud JM, Kirchhof B, Daha MR, den Hollander AI, Hoyng CB. Risk Alleles in CFH and ARMS2 Are Independently Associated with Systemic Complement Activation in Age-related Macular Degeneration. Ophthalmology 2012; 119:339-46. [DOI: 10.1016/j.ophtha.2011.07.056] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 07/04/2011] [Accepted: 07/29/2011] [Indexed: 12/26/2022] Open
|
13
|
Siezenga MA, Shaw PKC, Daha MR, Rabelink TJ, Berger SP. Low Mannose-Binding Lectin (MBL) genotype is associated with future cardiovascular events in type 2 diabetic South Asians. A prospective cohort study. Cardiovasc Diabetol 2011; 10:60. [PMID: 21729275 PMCID: PMC3157421 DOI: 10.1186/1475-2840-10-60] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 07/05/2011] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND South Asians have a high burden of type 2 diabetes and vascular complications. Vascular inflammation is considered central in the pathophysiology of atherosclerosis, and the complement system is thought to play an important role. Mannose-Binding Lectin (MBL), which activates the lectin pathway of complement activation, has been introduced as a risk marker of vascular damage. The present study explores the association of MBL levels, genotype and cardiovascular events in type 2 diabetic South Asians. METHODS We conducted a prospective observational study. A cohort consisting of 168 type 2 diabetic South Asians was followed for a median duration of 7.66 years. At baseline, MBL levels and genotype were determined. The association with future cardiovascular events was assessed by Cox proportional hazard regression. RESULTS During follow-up, 31 cardiovascular events occurred in 22 subjects (11 men, 11 women). The O/O genotype was significantly associated with the occurrence of cardiovascular events (hazard ratio 3.42, 95%CI 1.24-9.49, P = 0.018). However, log MBL levels were not associated with the occurrence of cardiovascular events (hazard ratio 0.93, 95% CI 0.50-1.73). CONCLUSIONS In type 2 diabetic South Asians, the O/O MBL genotype is associated with cardiovascular events, although single serum MBL levels are not.
Collapse
Affiliation(s)
- Machiel A Siezenga
- Department of Nephrology, Leiden University Medical Center, the Netherlands.
| | | | | | | | | |
Collapse
|