PDF(Pubmed)
Abstract：
The complement system, an important part of the innate system, is known to play a central role in many immune mediated kidney diseases. All parts of the complement system including the classical, alternative, and mannose-binding lectin pathways have been implicated in complement-mediated kidney injury. Although complement components are thought to be mainly synthesized in the liver and activated in the circulation, emerging data suggest that complement is synthesized and activated inside the kidney leading to direct injury. Urinary complement biomarkers are likely a better reflection of inflammation within the kidneys as compared to traditional serum complement biomarkers which may be influenced by systemic inflammation. In addition, urinary complement biomarkers have the advantage of being non-invasive and easily accessible. With the rise of therapies targeting the complement pathways, there is a critical need to better understand the role of complement in kidney diseases and to develop reliable and non-invasive biomarkers to assess disease activity, predict treatment response and guide therapeutic interventions. In this review, we summarized the current knowledge on urinary complement biomarkers of kidney diseases due to immune complex deposition (lupus nephritis, primary membranous nephropathy, IgA nephropathy) and due to activation of the alternative pathway (C3 glomerulopathy, thrombotic microangiography, ANCA-associated vasculitis). We also address the limitations of current research and propose future directions for the discovery of urinary complement biomarkers.
摘要：
补充系统，先天系统的重要组成部分，已知在许多免疫介导的肾脏疾病中起着核心作用。补语系统的所有部分，包括经典，另类，和甘露糖结合凝集素途径与补体介导的肾损伤有关。尽管人们认为补体成分主要在肝脏中合成并在循环中被激活，新出现的数据表明，补体在肾脏内被合成和激活，导致直接损伤。与可能受全身性炎症影响的传统血清补体生物标志物相比，尿补体生物标志物可能更好地反映肾脏内的炎症。此外,尿补体生物标志物具有非侵入性和易于获得的优点。随着针对补体途径的疗法的兴起，迫切需要更好地了解补体在肾脏疾病中的作用，并开发可靠的非侵入性生物标志物来评估疾病活动，预测治疗反应并指导治疗干预。在这次审查中,我们总结了由于免疫复合物沉积引起的肾脏疾病的尿补体生物标志物的最新知识（狼疮性肾炎，原发性膜性肾病,IgA肾病）和由于旁路途径的激活（C3肾小球病，血栓性微血管造影,ANCA相关性血管炎）。我们还解决了当前研究的局限性，并提出了发现尿补体生物标志物的未来方向。
