TY - JOUR
T1 - The classical pathway triggers pathogenic complement activation in membranous nephropathy
AU - Seifert, Larissa
AU - Zahner, Gunther
AU - Meyer-Schwesinger, Catherine
AU - Hickstein, Naemi
AU - Dehde, Silke
AU - Wulf, Sonia
AU - Köllner, Sarah M.S.
AU - Lucas, Renke
AU - Kylies, Dominik
AU - Froembling, Sarah
AU - Zielinski, Stephanie
AU - Kretz, Oliver
AU - Borodovsky, Anna
AU - Biniaminov, Sergey
AU - Wang, Yanyan
AU - Cheng, Hong
AU - Koch-Nolte, Friedrich
AU - Zipfel, Peter F.
AU - Hopfer, Helmut
AU - Puelles, Victor G.
AU - Panzer, Ulf
AU - Huber, Tobias B.
AU - Wiech, Thorsten
AU - Tomas, Nicola M.
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - Membranous nephropathy (MN) is an antibody-mediated autoimmune disease characterized by glomerular immune complexes containing complement components. However, both the initiation pathways and the pathogenic significance of complement activation in MN are poorly understood. Here, we show that components from all three complement pathways (alternative, classical and lectin) are found in renal biopsies from patients with MN. Proximity ligation assays to directly visualize complement assembly in the tissue reveal dominant activation via the classical pathway, with a close correlation to the degree of glomerular C1q-binding IgG subclasses. In an antigen-specific autoimmune mouse model of MN, glomerular damage and proteinuria are reduced in complement-deficient mice compared with wild-type littermates. Severe disease with progressive ascites, accompanied by extensive loss of the integral podocyte slit diaphragm proteins, nephrin and neph1, only occur in wild-type animals. Finally, targeted silencing of C3 using RNA interference after the onset of proteinuria significantly attenuates disease. Our study shows that, in MN, complement is primarily activated via the classical pathway and targeting complement components such as C3 may represent a promising therapeutic strategy.
AB - Membranous nephropathy (MN) is an antibody-mediated autoimmune disease characterized by glomerular immune complexes containing complement components. However, both the initiation pathways and the pathogenic significance of complement activation in MN are poorly understood. Here, we show that components from all three complement pathways (alternative, classical and lectin) are found in renal biopsies from patients with MN. Proximity ligation assays to directly visualize complement assembly in the tissue reveal dominant activation via the classical pathway, with a close correlation to the degree of glomerular C1q-binding IgG subclasses. In an antigen-specific autoimmune mouse model of MN, glomerular damage and proteinuria are reduced in complement-deficient mice compared with wild-type littermates. Severe disease with progressive ascites, accompanied by extensive loss of the integral podocyte slit diaphragm proteins, nephrin and neph1, only occur in wild-type animals. Finally, targeted silencing of C3 using RNA interference after the onset of proteinuria significantly attenuates disease. Our study shows that, in MN, complement is primarily activated via the classical pathway and targeting complement components such as C3 may represent a promising therapeutic strategy.
UR - http://www.scopus.com/inward/record.url?scp=85146944779&partnerID=8YFLogxK
U2 - 10.1038/s41467-023-36068-0
DO - 10.1038/s41467-023-36068-0
M3 - Journal article
C2 - 36709213
AN - SCOPUS:85146944779
SN - 2041-1723
VL - 14
JO - Nature Communications
JF - Nature Communications
IS - 1
M1 - 473
ER -