Mutations in complement C3 predispose to development of atypical hemolytic uremic syndrome

Author:

Frémeaux-Bacchi Veronique1,Miller Elizabeth C.2,Liszewski M. Kathryn2,Strain Lisa3,Blouin Jacques1,Brown Alison L.4,Moghal Nadeem5,Kaplan Bernard S.6,Weiss Robert A.7,Lhotta Karl8,Kapur Gaurav9,Mattoo Tej9,Nivet Hubert10,Wong William11,Gie Sophie12,de Ligny Bruno Hurault13,Fischbach Michel14,Gupta Ritu2,Hauhart Richard2,Meunier Vincent15,Loirat Chantal16,Dragon-Durey Marie-Agnès1,Fridman Wolf H.1,Janssen Bert J. C.17,Goodship Timothy H. J.18,Atkinson John P.2

Affiliation:

1. Service d'Immunologie Biologique, Hôpital Européen Georges Pompidou, Paris, and INSERM UMRS 872, Cordeliers Research Center, Paris, France;

2. Division of Rheumatology, Washington University School of Medicine, St Louis, MO;

3. Northern Molecular Genetics Service and

4. Departments of Renal Medicine and

5. Paediatric Nephrology, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, United Kingdom;

6. Division of Nephrology, Children's Hospital of Philadelphia, PA;

7. Paediatric Nephrology, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY;

8. Division of Clinical Nephrology, Department of Internal Medicine, Innsbruck University Hospital, Innsbruck, Austria;

9. Pediatric Nephrology, Children's Hospital of Michigan, Detroit;

10. Unité de Néphrologie Pédiatrique, Centre Hospitalier de Tours, Tours, France;

11. Starship Children's Hospital, Auckland, New Zealand;

12. Département de Médecine de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Rennes, Hôpital Sud, Rennes, France;

13. Service de Néphrologie Transplantation Renale, Hôpital Clemenceau, Caen, France;

14. Service de Pédiatrie, Hôpital de Hautepierre, Strasbourg, France;

15. Service de Medecine Interne, Hôpital Robert Boulin, Libourne, France;

16. Service de Néphrologie Pédiatrique, Hôpital Robert-Debré, Paris, France;

17. Crystal and Structural Chemistry, Bijvoet Center for Biomolecular Research, Faculty of Science, Utrecht University, Utrecht, The Netherlands; and

18. Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, United Kingdom

Abstract

AbstractAtypical hemolytic uremic syndrome (aHUS) is a disease of complement dysregulation. In approximately 50% of patients, mutations have been described in the genes encoding the complement regulators factor H, MCP, and factor I or the activator factor B. We report here mutations in the central component of the complement cascade, C3, in association with aHUS. We describe 9 novel C3 mutations in 14 aHUS patients with a persistently low serum C3 level. We have demonstrated that 5 of these mutations are gain-of-function and 2 are inactivating. This establishes C3 as a susceptibility factor for aHUS.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

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