Immunohistochemical demonstration of membrane cofactor protein (MCP) of complement in normal and diseased kidney tissues.

The immunohistochemically stained membrane cofactor protein of complement (MCP/CD46), one of the complement regulatory proteins, was up-regulated in some diseased kidney tissues. MCP in diseased kidneys was strongly concentrated along the glomerular capillary walls as well as in the mesangial regions, while MCP in normal kidneys was weakly detected in all glomerular structural cells and in the epithelial cells of tubules. Since the enhanced staining was noted in those areas where depositions of C3b/C3c occurred, ongoing complement reaction might be responsible for the up-regulation of MCP expression. MCP expression may be up-regulated by complement fragments generated during complement activation in glomerulonephritis. Furthermore, anti-MCP staining was stronger in intensity in patients with moderate to massive proteinuria, indicating that up-regulation of MCP expression could be directly correlated to the kidney damage.     

Ontogenesis of the glomerular C3b receptor (CR1) in fetal human kidney

Ontogenesis of the glomerular C3b receptor (CR1) was studied in kidneys from 16 fetuses aged from 9 to 32 weeks, using immunohistochemical techniques and the F(ab')2 fragment of a monospecific rabbit antibody to CR1, and adherence of C3b-coated sheep erythrocytes. By indirect immunofluoresence, anti-CR1 stained presumptive glomerular epithelium from the end of the S-body stage of nephron differentiation. Staining increased with visceral epithelial cell proliferation and with differentiation of the nephron from the subcortical to the juxtamedullary part of the fetal kidney. Using electron microscopy and an indirect immunoperoxidase technique, CR1 antigen was detected on the plasma membrane in the basolateral part of primitive podocytes from the late S-body stage, following the acquisition by podocytes of the capacity to synthetize a basal lamina. Endothelial cells and mesangial cells did not stain for CR1 antigen. CR1 antigen was expressed by podocytes from the same stage of glomerular differentiation as was the CALLA antigen. Glomerular expression of CR1 on podocytes preceded that of Ia on glomerular endothelial cells. C3b-bearing sheep erythrocytes only adhered to clover-like lobulated glomeruli at a late stage of glomerular differentiation. Glomerular CR1, a specific marker of glomerular capillary epithelial cells is one of the earliest markers expressed by resident glomerular cells during renal ontogenesis.     

Preferential inactivation of the C5 convertase of the alternative complement pathway by factor I and membrane cofactor protein (MCP).

Human C3b bound to the ghost of sheep erythrocytes (E*) via activation of the alternative complement pathway (E*AC3b) consists of four major constituents on SDS-PAGE of 350, 260, 210 and 180 kDa. 350 kDa C3b is a dimeric form of C3b in which the alpha' chain of one C3b binds covalently to that of the other C3b. This complex is presumed to serve as a core for the alternative pathway C5 convertase. The other C3b populations are monomers complexed with membrane proteins or sugars. Using E*AC3b (C3b labeled) as a substrate, we have investigated functional properties of membrane cofactor protein (MCP), which is an integral membrane protein with C3b-binding and factor I-dependent cofactor activities. In conjunction with factor I, MCP was found to degrade the protein-bound C3b preferentially including the 350 kDa dimer. There was a similar but lesser tendency of this selective cleavage of C3b-dimer by CR1 but not by factor H or C4bp. In contrast to CR1 and factor H, detergent solubilization of EAC3b was required for MCP to fully express its cofactor activity for this selective degradation of C3b. We next separated the C3b dimer from the monomers and assessed their ability to assemble the alternative C5 convertase. The C3b dimer but not the monomers expressed C5 convertase activity following the addition of factors B and D, C5 and Ni2+. Kinetic analysis of the degradation of the C3b dimer by MCP and factor I suggested that only one C3b was efficiently converted to C3bi and this occurred concomitant with a decrease in C5 convertase activity. These results suggest that MCP has the ability to more efficiently interact with protein-bound C3b and that this may relate as well to its preferential ability to irreversibly inactivate the C5 convertase.     

Non-small cell lung cancer cells produce a functional set of complement factor I and its soluble cofactors

The complement system is important for protection from invading pathogens, removal of waste products and guidance of the immune response. Furthermore, complement can be also targeted to cancer cells. However, membrane-bound inhibitors over-expressed by certain types of tumor cells restrict the cytotoxic activity of complement. Herein we report that non-small cell lung cancer (NSCLC) cells produce soluble complement inhibitors factor I (FI) and C4b-binding protein (C4BP). FI is a serine protease capable of degrading the activated complement components C3b and C4b, whilst C4BP acts as its cofactor. Furthermore, NSCLC cells express membrane-bound regulators and shed membrane cofactor protein (MCP), which shares cofactor function with C4BP. Secretion of FI from NSCLC cells was higher than previously reported for any non-hepatic source and FI produced by these cells could efficiently support cleavage of C3b and C4b. In vitro functional assays revealed that additional FI significantly decreased C3 deposition and complement-dependent lysis, particularly when cofactors were added. Our results demonstrate that soluble inhibitors produced by NSCLC cells may provide further protection from complement beyond the level ensured by membrane-bound inhibitors and, as such, contribute to the aggressive phenotype of these lung cancer cells.     

Granulocyte-Dependent Extracellular Cytotoxicity is Enhanced by Complement C3bi and Independent of Phagocytosis

We have evaluated phagocytosis, C3-binding and cytotoxicity of human leukocytes simultaneously, using IgM-sensitized C3-fragment-bearing sheep erythrocytes (EAC3b, EAC3bi) as targets. In this method, 51Cr-labelled EAC3b or EAC3bi were added to human peripheral granulocytes anchored by fibronectin onto microtitre plate wells. The degrees of haemolysis, binding and ingestion of the target cells were estimated from the radioactivity released. We found that the granulocytes predominantly lysed EAC3bi but not EAC3b or EAC4b. EAC3bi lysis elicited from granulocytes was as effective as that from lymphocytes under the same assay conditions. However, one difference in the cytolysis of the two effector cells was that EAC3bi bound efficiently to all of the granulocytes similarly to EAC3b, whereas it bound to only 4% of the lymphocytes. The bound cells did not appear to be efficiently phagocytosed by the granulocytes. Blocking studies using antibodies suggested that C3bi receptors, CR3 and CR4, but not other C3-binding proteins, C3b/C4b receptor (CR1), membrane cofactor protein (MCP) or decay-accelerating factor (DAF), are involved in granulocyte-mediated haemolysis. We speculate that simultaneous stimulation of the C3bi receptors and the fibronectin receptor results in elicitation of cytotoxicity by granulocytes.     

肾小球C4d沉积在慢性肾病早期诊断及预后的价值分析

目的 分析肾小球沉积C4d在慢性肾病中的价值,为临床提供可靠依据。方法 本次研究选自2014年1月～2017年1月医院肾内科肾脏病理检验患者194例,其中慢性肾脏病86例,急性肾损伤性疾病108例,均采用免疫组织化学检验肾小球C4d,进行沉积分型,慢性肾脏病对象划分为有效组（8周内随访蛋白尿得到控制）、对照组。对比慢性肾脏病、急性肾损伤患者肾小球C4d沉积情况,分析慢性肾脏病在C4d沉积表达中是否存在独立作用。分析肾小球C4d沉积是否在慢性病治疗中起到作用。结果 慢性肾脏病肾小球C4d阳性率、毛细血管袢区沉积伴系膜区沉积比重高于急性肾脏病对象,差异有统计学意义（P＜0.05）。肾小球毛细血管袢区C4d沉积成为慢性肾脏病疾病未获得控制的独立影响因素（P＜0.05）。结论 肾小球C4d沉积在早期诊断及判断预后具有价值,肾小球C4d毛细血管袢区沉积伴系膜区沉积慢性肾脏病风险较高,同时在疗效预测上有更高的价值。     

Complement activation and expression of membrane regulators in the middle ear mucosa in otitis media with effusion.

The aetiopathogenesis of chronic otitis media with effusion (OME) in children is not yet fully understood. OME is characterized by metaplasia of the epithelium and accumulation of sticky, glue-like effusion in the middle ear containing different mediators of inflammation, including activation fragments of the complement system. Here we examined whether the fluid phase complement activation is reflected in the middle ear mucosa and how the mucosa is protected against the cytolytic activity of complement. Mucosal biopsies from 18 middle ears of children with a history of chronic OME were taken. The biopsies were analysed by immunofluorescence microscopy after staining for complement fragments iC3b/C3c, C3d and C9, and regulators membrane cofactor protein (MCP; CD46), decay-accelerating factor (DAF; CD55) and protectin (CD59). There was a strong staining for iC3b/C3c, and a weaker one for C3d and C9 on the surface of the middle ear epithelial cells of OME patients but not in controls without OME. MCP was expressed on the hyperplastic three to four outer cell layers of the epithelium, while CD59 was expressed throughout the middle ear mucosa. The results suggest a strong ongoing complement activation and consequent inflammation in the middle ear cavity. Unrestricted complement damage of the epithelial lining is prevented by the strong expression of MCP and CD59.     

Implications of the initial mutations in membrane cofactor protein (MCP; CD46) leading to atypical hemolytic uremic syndrome

The hemolytic uremic syndrome is characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. There are two general types. One occurs in epidemic form and is diarrheal associated (D+HUS). It has a good prognosis. The second is a rare form known as atypical (aHUS), which may be familial or sporadic, and has a poor prognosis. aHUS is increasingly recognized to be a disease of defective complement regulation, particularly cofactor activity. Mutations in membrane cofactor protein (MCP; CD46) that predispose to the development of aHUS were first identified in 2003. MCP is a membrane-bound complement regulator that acts as a cofactor for the factor I-mediated cleavage of C3b and C4b deposited on host cells. More than 20 different mutations in MCP have now been identified in patients with aHUS. Many of these mutants have been functionally characterized and have helped to define the pathogenic mechanisms leading to aHUS development. Over 75% of the reported mutations cause a reduction in MCP expression, due to homozygous, compound heterozygous or heterozygous mutations. This deficiency of MCP leads to inadequate control of complement activation on endothelial cells after an initiating injury. The remaining MCP mutants are expressed, but demonstrate reduced ligand (C3b/C4b) binding capacity and cofactor activity of MCP. MCP mutations in aHUS demonstrate incomplete penetrance, indicating that additional genetic and environmental factors are required to manifest disease. MCP mutants as a cause of aHUS have a favorable clinical outcome in comparison to patients with factor H (CFH) or factor I (IF) mutations. In 90% of the renal transplants performed in patients with MCP-HUS, there has been no recurrence of the primary disease, whilst >50% of factor I or factor H deficient patients have had a prompt recurrence. This highlights the importance of defining and characterizing the underlying genetic defects in patients with aHUS.     

Molecular cloning of a pig homologue of membrane cofactor protein (CD46)

Organs of transgenic pigs that express human complement regulatory proteins are under assessment as an alternative to transplantation. A major barrier to the transplantation of pig organs is the hyperacute rejection caused by pre-existing antibodies and complement. Pig cells are very susceptible to human complement, presumably because pig cell- surface complement regulatory proteins are inefficient against it. Expression of human complement regulatory proteins, such as decay- accelerating factor and membrane cofactor proteins (MCP or CD46), by means of transgenes would confer resistance to human complement upon pig cells, thereby preventing hyperacute rejection. To express sufficient levels of human complement regulatory proteins at appropriate sites, regulatory elements of genes of pig membrane-bound complement regulatory proteins would be useful. To obtain their cDNAs, we transfected human cells with a pig cDNA library, selected cells by incubation with pig complement and rescued the plasmids. We cloned a cDNA for the pig homologue of MCP, pMCP. The cDNA encoded a predicted protein of 363 amino acids with 42% amino acid identity with human MCP. The pMCP consisted of four short consensus repeats, a Ser/Thr/Pro-rich domain, and transmembrane and cytoplasmic domains. Recombinant soluble pMCP that lacked transmembrane and cytoplasmic domains had factor I cofactor activity in C3b cleavage, indicating that it is functionally, as well as structurally homologous to MCP. FACS analysis with anti-pMCP mAb demonstrated that pMCP is expressed on all blood leukocytes, erythrocytes, and on endothelial and epithelial cell lines.      

The effect of macrophages on the metabolism of glomerular cells: preliminary studies

Human glomerular epithelial and mesangial cells were grown in vitro and shown to have distinctive morphologic and functional characteristics. Glomerular epithelial cells or mesangial cells cultured in wells of flat-bottom microtiter plates were treated for 4 hr with dialyzed macrophage supernatants obtained from cultures of mouse peritoneal macrophages or human peripheral monocytes. DNA, RNA, and protein synthesis were evaluated by incorporation of radioactive precursors. Macrophage supernatants stimulated RNA and protein synthesis in epithelial cells but failed to stimulate DNA synthesis. The macrophage factor(s) showed a dose-response activity, was nondialyzable, was destroyed by freezing and thawing, and did not seem to be species specific. In contrast to the results obtained with glomerular epithelial cells, mesangial cell DNA synthesis was stimulated by macrophage supernatants. The observed metabolic effects of macrophage products on glomerular cells in vitro are consistent with observations of in vivo glomerular response to injury in which epithelial cells may be activated to form new basement membrane while mesangial cells may respond by proliferating. These data further support the theory of macrophage involvement in the pathology of glomerulonephritis.     

人补体膜辅助调节蛋白MCP的基因克隆及其真核表达的研究

目的　克隆获得编码人补体膜辅助调节蛋白（ ＭＣＰ） 的ｃＤＮＡ,并对其在真核细胞的表达及功能进行研究。方法　应用ＲＴＰＣＲ 方法,从Ｕ９３７ 细胞总ＲＮＡ 中扩增编码人ＭＣＰ 分子的ｃＤＮＡ片段, 快速克隆于ｐＧＥＭＴＥａｓｙ 载体,测定其序列。将该片段重组于ｐＬＸＳＮ 载体,电穿孔转染ＮＩＨ３Ｔ３ 细胞,经ＦＡＣＳ 检测筛选表达ＭＣＰ 的阳性细胞克隆,用补体溶破试验鉴定其抑制人补体溶破的功能。结果　ＲＴＰＣＲ 扩增得到１ １４４ｂｐ 的编码人ＭＣＰ 分子的ｃＤＮＡ 片段,序列分析表明该ｃＤＮＡ编码的蛋白为ＳＴＣ＋ ＣＹＴ２ 亚型。细胞转染筛选获得多个表达ＭＣＰ 的ＮＩＨ３Ｔ３ 阳性细胞克隆,补体溶破试验证实其具有抑制人补体经典途径和旁路途径溶破的功能。结论　本研究为进一步探讨不同亚型结构的ＭＣＰ 分子与功能的关系及其应用奠定了基础。     

Distribution of membrane cofactor protein of complement on human peripheral blood cells. An altered form is found on granulocytes

Membrane cofactor protein (MCP) of human complement is an iC3/C3b-binding glycoprotein with a characteristic two-band (63 kDa and 55 kDa) pattern on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Using affinity chromatography, it has been found on human mononuclear cells and platelets. MCP has been purified and shown to be a cofactor for the I-mediated cleavage of C3b. A rabbit polyclonal antibody was produced to the purified protein and this reagent employed to analyze the distribution of MCP on human peripheral blood cells. Flow cytometric analysis indicated that MCP is unimodally present on all platelets, granulocytes, T helper lymphocytes, T suppressor/cytotoxic lymphocytes, B lymphocytes, natural killer cells and monocytes but not erythrocytes. The presence of MCP on granulocytes was unexpected. To evaluate this, MCP was isolated by immunoprecipitation and analyzed by SDS-PAGE followed by autoradiography. The Mr of granulocyte MCP was that of a single broad band in which the typical two-band pattern could not be distinguished. Alterations in the conditions of the affinity column procedure increased the efficiency of the isolation of monocyte MCP and led to the reproducible isolation of granulocyte MCP. These results indicate that MCP of granulocytes has both structural and functional differences compared to MCP of plateletes and mononuclear cells. The wide distribution of MCP among peripheral blood cells supports the concept that MCP is important in the protection of host cells from complement-mediated damage.     

C3 and C4 gene expression and interferon-gamma-mediated regulation in human glomerular mesangial cells.

The glomerular mesangial cell (GMC) plays a key role in the maintenance of glomerular structure and function and in the mediation of glomerular injury. To explore the potential of this cell to produce complement and react to local inflammatory signals, we studied the synthesis and regulation of the third and fourth components of complement in cultured human GMC. Using metabolic labelling and immunoprecipitation, we found that C3 and C4 polypeptide chains were synthesized and secreted by GMC. Interferon-gamma (IFN-gamma) led to an increase in C4 protein synthesis, but not C3 synthesis. There was a corresponding increase in C4 mRNA in IFN-gamma-activated cells, but no increase in C3 mRNA, as determined by semi-quantitative polymerase chain reaction (PCR) estimation. These results demonstrate that human GMC can synthesize C3 and C4 proteins, and that regulation of expression of the C4 gene is mediated by IFN-gamma. We hypothesize that GMC production of complement could influence the clearance of immune aggregates by the kidney and the mediation of glomerular injury.     

Effect of fibrin matrix on growth of glomerular cells.

Rat glomerular cells were grown either in or on fibrin clots prepared from rat plasma to assess the effect of native fibrin on the growth of glomerular epithelial and mesangial cells. Progressive fibrinolysis was observed in glomerular explant cultures without epsilon-aminocaproic acid (EACA), an inhibitor of plasminogen activation. The lytic areas extended as the cell number of glomerular explant outgrowths increased. Glomerular cultures containing 0.5% EACA showed complete inhibition of fibrinolysis. Under this condition, the glomerular outgrowths developed only when the glomerular explants were seeded on the surface of fibrin matrix. While the explants were embedded in the fibrin matrix, few cells could grow out of explants. The more prosperous growth of glomerular epithelial cells in the lytic areas and the lack of intimate binding of glomerular epithelial cell membrane with fibrin fibers implied that fibrin might hinder the outgrowth of glomerular epithelial cells. The mesangial cells, whether growing on the surface of or embedded in the fibrin matrix, showed no fibrinolytic activity. Inhibition of fibrinolysis did not alter the growth pattern of mesangial cells. In addition, mesangial cells exhibited extensive binding of fibrin fibers on their cell surface and developed conspicuous arborization of their cell processes. These features suggested a close affinity between mesangial cells and fibrin matrix. These experiments have addressed our attention to the particular roles of the visceral epithelial cells and mesangial cells in the pathogenesis of fibrin-related glomerulonephritis.     

Distribution of membrane cofactor protein (MCP/CD46) on pig tissues. Relevance To xenotransplantation.

Membrane cofactor protein (MCP; CD46) is a 50-60 000 MW glycoprotein, expressed on a wide variety of cells and tissues in man, which plays an important role in regulating complement activation. Human MCP has also been shown to be the receptor for measles virus. We have recently identified the pig analogue of MCP and demonstrated that pig MCP has cofactor activity for factor I-mediated cleavage of C3b when these components are derived either from pig or human. As a consequence, pig MCP is an efficient regulator of the classic and alternative pathways of human and pig complement. In order to define the potential importance of MCP in protecting against complement activation in the pig, we have conducted a comprehensive survey of its distribution in pig cells and organs. As in humans, MCP in the pig is broadly and abundantly distributed. Pig MCP is highly expressed on all circulating cells, including erythrocytes, in contrast to its absence on human erythrocytes. Multiple isoforms of MCP are found on cells and in tissues, probably representing products of alternative splicing analogous to those found in man. MCP is abundantly expressed throughout all tissues examined with particularly strong staining on the vascular endothelium. Connective tissue elements within liver and testis are also strongly stained by anti-pig MCP antibodies. Pig MCP is expressed only weakly on skeletal muscle cells and expression is absent from smooth muscle cells in the lung and vessel walls, sites at which human MCP is expressed. Of particular note, MCP is not expressed in B-cell areas of the germinal centres of lymph nodes.     

C3b receptors in glomerular disease.

Using two indicator systems--sheep erythrocytes or fluoresceinated S. typhi coated with C3b the presence of a receptor for C3b (but not C3d) in the normal human glomerulus is confirmed. No receptor could be detected in other species tested (mouse, rat, guinea-pig, rabbit and rhesus monkey). Binding of indicator particles was reduced or lost in diseases associated with glomerular capillary deposition of C3, but not in those with mesangial deposition alone. However in some cases the receptor was lost in the absence of detectable C3 deposition. No receptors were detected in proliferating cells in glomerular crescents.     

The molecular and structural bases for the association of complement C3 mutations with atypical hemolytic uremic syndrome

Atypical hemolytic uremic syndrome (aHUS) associates with complement dysregulation caused by mutations and polymorphisms in complement activators and regulators. However, the reasons why some mutations in complement proteins predispose to aHUS are poorly understood. Here, we have investigated the functional consequences of three aHUS-associated mutations in C3, R592W, R161W and I1157T. First, we provide evidence that penetrance and disease severity for these mutations is modulated by inheritance of documented “risk” haplotypes as has been observed with mutations in other complement genes. Next, we show that all three mutations markedly reduce the efficiency of factor I-mediated C3b cleavage when catalyzed by membrane cofactor protein (MCP), but not when catalyzed by factor H. Biacore analysis showed that each mutant C3b bound sMCP (recombinant soluble MCP; CD46) at reduced affinity, providing a molecular basis for its reduced cofactor activity. Lastly, we show by electron microscopy structural analysis a displacement of the TED domain from the MG ring in C3b in two of the C3 mutants that explains these defects in regulation. As a whole our data suggest that aHUS-associated mutations in C3 selectively affect regulation of complement on surfaces and provide a structural framework to predict the functional consequences of the C3 genetic variants found in patients.     

Cell-associated complement regulatory proteins and their relation to disease processes]

C3-deposition is a key step for activation of the complement system, which involves C9-mediated immunocytolysis, immunoadherence, C3 receptor-mediated phagocytosis, NK potentiation, anaphylatoxin release, and amplification of C3 activation. Foreign material is eliminated even in the preimmune stage by these complement functions. Self cells, on the other hand, must circumvent the C3-attack, so that they express complement regulatory proteins, namely C3b/C4b receptor (CR1, CD35), decay-accelerating factor (DAF, CD55), membrane cofactor protein (MCP, CD46). We herein review the properties of these regulatory proteins and discuss the relationships between disease processes and the aberrance of these regulatory proteins.     

C3, C4, factor B and HLA-DR alpha mRNA expression in renal biopsy specimens from patients with IgA nephropathy.

The deposition of complement in the kidney mesangium is a constant finding associated with renal injury in IgA nephropathy, even though IgA does not bind complement. We have previously reported that complement gene expression in the kidney increases concurrently with the progression of immune complex disease in murine lupus nephritis. We have now studied the expression of C3, C4, factor B and HLA-DR alpha mRNA by in situ hybridization in renal biopsy specimens of patients with IgA nephropathy and compared these findings to those in patients with other immune-mediated diseases of the kidney, hereditary nephritis and normal kidney. In IgA nephropathy, C3 and factor B mRNA were expressed in the renal tubular epithelial cells, while no expression of either C3 or factor B mRNA was apparent in the glomerulus. Specimens from patients with other immune-mediated forms of chronic glomerulonephritis also showed a similar pattern of expression of C3 and factor B mRNA only in the tubules, but not in the glomerules. However, C3 and factor B mRNA were not found in normal kidney tissue or biopsy specimens from patients with hereditary nephritis. C4 mRNA was expressed in the tubular epithelial cells in all specimens examined, indicating that C4 mRNA is constitutively expressed in the human kidney. In IgA nephropathy HLA-DR alpha mRNA was observed in the interstitium, but not the tubules or glomerular cells. In contrast, HLA-DR alpha mRNA was present in the glomerulus and scattered in the interstitium in other immune-mediated kidney diseases. There was no expression of HLA-DR alpha mRNA in hereditary nephritis or normal kidney. Our findings, which reflect the immunopathogenic events in vivo, provide new insights as to the interpretation of the molecular immunology of this immune complex disease.