Are serum C3 levels or kidney C3 deposits useful markers for predicting outcomes in patients with ANCA-associated vasculitis?
© 2023 The Authors..
Introduction: Complement activation emerged as a key actor of anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV). Whether serum levels of C3 (sC3) or C3 kidney deposition may help to refine the prognosis of AAV remains elusive.
Methods: Retrospective multicentric study that included 154 patients with a first flare of AAV and sC3 (n = 143) or C3 kidney staining (n = 95) available at diagnosis. Clinical presentations, kidney pathology, and survival of patients with normal or low sC3 were compared using univariate analyses, Kaplan-Maier curves with log-rank comparison, or multivariate Cox' model, as appropriate.
Results: 20 patients (14 %) had low sC3. sC3 (as bivariate low/normal or as a continuous variable) was associated with 5-year mortality but not with kidney survival. C3 kidney deposition (C3+) was identified in 23 patients who were characterized by more frequent chronic hypertension and lower eGFR at presentation (p = 0.04). C3+ correlated with IgG, IgM, C1q deposition (p = 0.07, p < 0.0001 and p = 0.003, respectively). Chronicity and activity scores were similar in C3+ and C3- patients. Among C3+ patients, those with C3 deposition ≥2+ had lower eGFR at presentation (p = 0.006) and were more frequently classified as sclerotic using the Berden classification (p = 0.04) and as 'high risk' using the Brix score (p = 0.03). However, eGFR improvement following induction regimen was similar between C3+ and C3- patients, and kidney survival at 5 years was similar.
Conclusions: Correlation of sC3 with mortality confirms mechanistic links between complement pathways and AAV, but the lack of clear predictive sC3 cut-off and the similar kidney outcome irrespective of C3 deposition precludes their use as biomarkers of AAV outcomes and response to treatment.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
Journal of translational autoimmunity - 7(2023) vom: 05. Dez., Seite 100217 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cassard, Alexis [VerfasserIn] |
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| Anmerkungen: |
Date Revised 26.10.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.jtauto.2023.100217 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363693629 |
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| 100 | 1 | |a Cassard, Alexis |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Are serum C3 levels or kidney C3 deposits useful markers for predicting outcomes in patients with ANCA-associated vasculitis? |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 26.10.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 The Authors. | ||
| 520 | |a Introduction: Complement activation emerged as a key actor of anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV). Whether serum levels of C3 (sC3) or C3 kidney deposition may help to refine the prognosis of AAV remains elusive | ||
| 520 | |a Methods: Retrospective multicentric study that included 154 patients with a first flare of AAV and sC3 (n = 143) or C3 kidney staining (n = 95) available at diagnosis. Clinical presentations, kidney pathology, and survival of patients with normal or low sC3 were compared using univariate analyses, Kaplan-Maier curves with log-rank comparison, or multivariate Cox' model, as appropriate | ||
| 520 | |a Results: 20 patients (14 %) had low sC3. sC3 (as bivariate low/normal or as a continuous variable) was associated with 5-year mortality but not with kidney survival. C3 kidney deposition (C3+) was identified in 23 patients who were characterized by more frequent chronic hypertension and lower eGFR at presentation (p = 0.04). C3+ correlated with IgG, IgM, C1q deposition (p = 0.07, p < 0.0001 and p = 0.003, respectively). Chronicity and activity scores were similar in C3+ and C3- patients. Among C3+ patients, those with C3 deposition ≥2+ had lower eGFR at presentation (p = 0.006) and were more frequently classified as sclerotic using the Berden classification (p = 0.04) and as 'high risk' using the Brix score (p = 0.03). However, eGFR improvement following induction regimen was similar between C3+ and C3- patients, and kidney survival at 5 years was similar | ||
| 520 | |a Conclusions: Correlation of sC3 with mortality confirms mechanistic links between complement pathways and AAV, but the lack of clear predictive sC3 cut-off and the similar kidney outcome irrespective of C3 deposition precludes their use as biomarkers of AAV outcomes and response to treatment | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a ANCA | |
| 650 | 4 | |a Complement C3 | |
| 650 | 4 | |a Dialysis | |
| 650 | 4 | |a Survival | |
| 650 | 4 | |a Vasculitis | |
| 700 | 1 | |a Kounde, Clément |e verfasserin |4 aut | |
| 700 | 1 | |a Bouillet, Laurence |e verfasserin |4 aut | |
| 700 | 1 | |a Goulenok, Tiphaine |e verfasserin |4 aut | |
| 700 | 1 | |a Ribes, David |e verfasserin |4 aut | |
| 700 | 1 | |a Mesbah, Rafik |e verfasserin |4 aut | |
| 700 | 1 | |a Langlois, Vincent |e verfasserin |4 aut | |
| 700 | 1 | |a Delas, Audrey |e verfasserin |4 aut | |
| 700 | 1 | |a Fortenfant, Françoise |e verfasserin |4 aut | |
| 700 | 1 | |a Humbert, Sébastien |e verfasserin |4 aut | |
| 700 | 1 | |a Lebas, Céline |e verfasserin |4 aut | |
| 700 | 1 | |a Belliere, Julie |e verfasserin |4 aut | |
| 700 | 1 | |a Kerschen, Philippe |e verfasserin |4 aut | |
| 700 | 1 | |a Chauveau, Dominique |e verfasserin |4 aut | |
| 700 | 1 | |a Colombat, Magali |e verfasserin |4 aut | |
| 700 | 1 | |a Faguer, Stanislas |e verfasserin |4 aut | |
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