The proteome microenvironment determines the protective effect of preconditioning in cisplatin-induced acute kidney injury

1. Download high-res image (341KB)
2. Download full-size image

     

Retinal disease in the C3 glomerulopathies and the risk of impaired vision

Background: Dense deposit disease and atypical hemolytic uremic syndrome are often caused by Complement Factor H (CFH) mutations. This study describes the retinal abnormalities in dense deposit disease and, for the first time, atypical haemolytic uremic syndrome. It also reviews our understanding of drusen pathogenesis and their relevance for glomerular disease. Methods: Six individuals with dense deposit disease and one with atypical haemolytic uremic syndrome were studied from 2 to 40 years after presentation. Five had renal transplants. All four who had genetic testing had CFH mutations. Individuals underwent ophthalmological review and retinal photography, and in some cases, optical coherence tomography, and further tests of retinal function. Results: All subjects with dense deposit disease had impaired night vision and retinal drusen or whitish-yellow deposits. Retinal atrophy, pigmentation, and hemorrhage were common. In late disease, peripheral vision was restricted, central vision was distorted, and there were scotoma from sub-retinal choroidal neovascular membranes and atypical serous retinopathy. Drusen were present but less prominent in the young person with atypical uremic syndrome due to a heterozygous CFH mutation. Conclusions: Drusen are common in forms of C3 glomerulopathy caused by compound heterozygous or heterozygous CFH mutations. They are useful diagnostically but also impair vision. Drusen have an identical composition to glomerular deposits. They are also identical to the drusen of age-related macular degeneration, and may respond to the same treatments. Individuals with a C3 glomerulopathy should be assessed ophthalmologically at diagnosis, and monitored regularly for vision-threatening complications.     

Isolated Donor Specific Alloantibody-Mediated Rejection after ABO Compatible Liver Transplantation

Antibody-mediated rejection (AMR) after liver transplantation is recognized in ABO incompatible and xeno-transplantation, but its role after ABO compatible liver transplantation is controversial. We report a case of ABO compatible liver transplantation that demonstrated clinical, serological and histological signs of AMR without evidence of concurrent acute cellular rejection. AMR with persistently high titers of circulating donor specific antibodies resulted in graft injury with initial centrilobular hepatocyte necrosis, fibroedematous portal expansion mimicking biliary tract outflow obstruction, ultimately resulting in extensive bridging fibrosis. Immunofluorescence microscopy demonstrated persistent, diffuse linear C4d deposits along sinusoids and central veins. Despite intense therapeutic intervention including plasmapheresis, IVIG and rituximab, AMR led to graft failure. We present evidence that an antibody-mediated alloresponse to an ABO compatible liver graft can cause significant graft injury independent of acute cellular rejection. AMR shows distinct histologic changes including a characteristic staining profile for C4d.     

60Co辐照血红细胞CR1分子数目的变化

目的研究不同剂量60Co γ射线辐照全血在保存期内红细胞CR1分子数目的变化.方法应用酶联法定量测定经15～35GY五个照射剂量辐照全血在保存期内红细胞CR1分子数目.结果照射后1d,15～25GY剂量组红细胞CR1分子数目相互间比较及分别与对照组比较无明显差异(P＞0.05);经30、35GY辐照红细胞CR1分子数目分别与其他剂量组和对照组比较有明显差异(P＜0.05～0.01).另外,随着保存期的延长,各剂量组和对照组红细胞CR1分子数目呈阶梯式下降,尤其在照射后3d,30和35GY剂量组红细胞CR1分子数目接近于照射后7d水平,二者相互比较无明显差异(P＞0.05).结论在一定范围内(15～25GY)60Co γ射线剂量辐照对红细胞CR1分子数目无明显影响.     

脂质过氧化物与大鼠烫伤后急性肺损伤的关系

本文从体内氧自由基引发的链产物——LPO为主要指标,观察大鼠烫伤后LPO变化与血清CH_(50),PMN,以及肺血管通透性间的关系。结果表明:烫伤后急性肺损伤的发生与补体活化、激活PMN,使其在肺内聚集释放氧自由基,引发血管内皮细胞膜脂过氧化反应有关。     

Beyond C4d: Other Complement-Related Diagnostic Approaches to Antibody-Mediated Rejection

Complement is a multifunctional system of receptors and regulators as well as effector molecules. Both the pathogenic and diagnostic power of complement is based on the capacity of the complement system to amplify innate and adaptive immunity. This amplification is accomplished through two strategies: (1) enzymatic reactions in the complement cascade, and (2) stimulation of leukocytes, platelets and parenchymal cells through specific receptors or receptor-independent pore formation. The mechanisms by which complement mediates and modifies nonspecific inflammation, antibody-mediated injury and T-cell responses are of particular significance to the pathogenesis of transplant rejection. Understanding the mechanisms by which complement integrates the interactions of leukocytes, platelets and parenchymal cells offers opportunities to further refine the diagnosis of rejection.     

Chronological changes in the complement system in sepsis

The time courses of serum complement levels and the severity of sepsis were compared in two groups of septic patients, one in which the patients survived (surviving group) and one in which they did not (nonsurviving group). The components of the complement system, namely, C3a, C4a, C5a, CH50, C3, C4, and C5, were measured at several points in time after the diagnosis of sepsis had been established. A 2-antibody radioimmunoassay was used to measure C3a, C4a, and C5a; the latex agglutination test was used to measure C3 and C4; nephelometry was used to measure C5; and Meyer's 50% hemolysis method was used to measure CH50. Following the diagnosis of sepsis, the levels of CH50, C3, and C4 were significantly lower in the nonsurviving than the surviving group, while the levels of C3a and C4a were significantly higher in the nonsurviving than the surviving group. The C5a levels were significantly higher in the nonsurviving than the surviving group, although no significant intergroup differences were subsequently noted. These results suggest that the serum levels of C3a, C4a, C5a, CH50, C3, and C4 could serve as indices of the severity of sepsis. Thus, monitoring the complement system may be useful for predicting the outcome of patients with sepsis.     

华支睾吸虫病患者血清中免疫球蛋白和C_3含量的变化

本文分别采用 ELISA 双抗体夹心法和琼脂单向免疫扩散法检测了华支睾吸虫病患者血清中各类免疫球蛋白和 C_3的含量。结果显示:患者血清中 I gG、I gM 和 I gE 的水平明显高于正常对照组,I gA 的水平与正常人相比无明显改变;而 C_3的含量显著低于正常人。提示:人体感染华支睾吸虫病后,I gG、I gM 和 I gE 与相应的特异性抗体呈同步增高的趋势;补体和抗体协同参与华支睾吸虫病的免疫学发病机理,在此过程中消耗补体,使 C_3含量降低。