BACKGROUND C3 glomerulopathies(C3G)are a rare cause of kidney failure resulting from complement dysregulation.Small studies demonstrate a high rate of recurrence and poor outcomes in kidney transplantation.Treatment e...BACKGROUND C3 glomerulopathies(C3G)are a rare cause of kidney failure resulting from complement dysregulation.Small studies demonstrate a high rate of recurrence and poor outcomes in kidney transplantation.Treatment efficacy in this setting with eculizumab,a terminal complement inhibitor,is largely unknown.AIM To determine the outcomes of kidney transplantation in patients with C3G and the potential impact of eculizumab.METHODS We retrospectively studied kidney transplant recipients who underwent a post-transplant biopsy confirming C3G between January 1,1993 and December 31,2023 at a single center.Only the first episode of kidney transplant was reviewed.The electronic medical records were reviewed for post-transplant allograft function,indication for biopsy,time to biopsy from transplant,time to allograft failure from transplantation,post-C3G treatment,complement laboratory testing,and concurrent malignancy/infection.Reports,and when available slides and immunofluorescence/electron microscopic images,were re-reviewed by a renal pathologist.RESULTS A total of fifteen patients were included in this study.Fourteen patients had suspected recurrent disease,with a pre-transplant native kidney report of C3G.One patient developed de novo C3G.Median post kidney transplant clinical follow up time was 91 months.Median time to recurrence was 7 months with median graft survival of 48 months post kidney transplantation.The most common index biopsy pattern of injury was endocapillary prolif-erative glomerulonephritis(often with exudative features)with or without mesangial hypercellularity(56%)followed by membranoproliferative glomerulonephritis(25%).Most patients developed membranoproliferative glomerulonephritis pattern of injury on follow up biopsies(63%).Seven patients with recurrent disease received treatment with eculizumab with a median graft survival of 73 months,with five functioning grafts by the end of the study period.Seven patients with recurrent disease did not receive therapy,and all lost their graft with a median graft survival of 22 months(P=0.003).CONCLUSION C3G following kidney transplantation is mostly a recurrent disorder with a poor prognosis in untreated patients.Untreated recurrence has a poor prognosis with median allograft survival<2 years.Early treatment with eculizumab may improve transplant outcomes in patients with recurrent C3G.展开更多
本文旨在探究富含天冬氨酸尾1的单通道膜蛋白(Single-pass Membrane Protein With Aspartate Rich Tail1,Smdt1)对C3H10T1/2细胞增殖和成脂分化的调控效应。本研究将Smdt1基因的过表达和干扰载体转染至C3H10T1/2细胞模型,采用qPCR方法...本文旨在探究富含天冬氨酸尾1的单通道膜蛋白(Single-pass Membrane Protein With Aspartate Rich Tail1,Smdt1)对C3H10T1/2细胞增殖和成脂分化的调控效应。本研究将Smdt1基因的过表达和干扰载体转染至C3H10T1/2细胞模型,采用qPCR方法量化了增殖和成脂分化关键基因的表达水平变化,利用EdU染色检测细胞增殖活力,油红O染色方法鉴定脂滴积累的状态;进一步通过String database、Bio GRID、Int Act、GeneMANIA、DAVID和Genecard数据库构建Smdt1蛋白互作网络图。结果显示,在C3H10T1/2细胞中过表达Smdt1,极显著提升了增殖标志基因Pcna、Ki67、Cdk1及Cdk4的表达,EdU阳性细胞比例反映了细胞增殖速率加快;Smdt1极显著促进成脂分化关键基因Pparγ、Fabp4、-Adipoq的表达量,显著促进了Cebpα、Cebpβ的表达量,脂滴数量变多。在C3H10T1/2细胞体系中,干扰Smdt1,与增殖紧密相关的标志基因,包括Ki67、Pcna及Cdk1,其表达水平极显著降低,Cdk4的表达也呈现显著降低的趋势,反映在EdU增殖检测中,阳性细胞数量明显减少,细胞增殖活性受到抑制。进一步干扰Smdt1后,成脂分化途径的关键调控基因Cebpα、Pparγ、Cebpβ、Fabp4、Adipoq的表达均极显著降低,细胞内脂滴的数量也显著减少,细胞成脂分化能力削弱。蛋白功能预测发现,Smdt1能够与Mcu相互作用,参与线粒体钙离子转运、摄取和稳态。本研究发现Smdt1可以促进C3H10T1/2细胞增殖和成脂分化,为脂肪沉积的研究提供了新的方向。展开更多
文摘BACKGROUND C3 glomerulopathies(C3G)are a rare cause of kidney failure resulting from complement dysregulation.Small studies demonstrate a high rate of recurrence and poor outcomes in kidney transplantation.Treatment efficacy in this setting with eculizumab,a terminal complement inhibitor,is largely unknown.AIM To determine the outcomes of kidney transplantation in patients with C3G and the potential impact of eculizumab.METHODS We retrospectively studied kidney transplant recipients who underwent a post-transplant biopsy confirming C3G between January 1,1993 and December 31,2023 at a single center.Only the first episode of kidney transplant was reviewed.The electronic medical records were reviewed for post-transplant allograft function,indication for biopsy,time to biopsy from transplant,time to allograft failure from transplantation,post-C3G treatment,complement laboratory testing,and concurrent malignancy/infection.Reports,and when available slides and immunofluorescence/electron microscopic images,were re-reviewed by a renal pathologist.RESULTS A total of fifteen patients were included in this study.Fourteen patients had suspected recurrent disease,with a pre-transplant native kidney report of C3G.One patient developed de novo C3G.Median post kidney transplant clinical follow up time was 91 months.Median time to recurrence was 7 months with median graft survival of 48 months post kidney transplantation.The most common index biopsy pattern of injury was endocapillary prolif-erative glomerulonephritis(often with exudative features)with or without mesangial hypercellularity(56%)followed by membranoproliferative glomerulonephritis(25%).Most patients developed membranoproliferative glomerulonephritis pattern of injury on follow up biopsies(63%).Seven patients with recurrent disease received treatment with eculizumab with a median graft survival of 73 months,with five functioning grafts by the end of the study period.Seven patients with recurrent disease did not receive therapy,and all lost their graft with a median graft survival of 22 months(P=0.003).CONCLUSION C3G following kidney transplantation is mostly a recurrent disorder with a poor prognosis in untreated patients.Untreated recurrence has a poor prognosis with median allograft survival<2 years.Early treatment with eculizumab may improve transplant outcomes in patients with recurrent C3G.
文摘本文旨在探究富含天冬氨酸尾1的单通道膜蛋白(Single-pass Membrane Protein With Aspartate Rich Tail1,Smdt1)对C3H10T1/2细胞增殖和成脂分化的调控效应。本研究将Smdt1基因的过表达和干扰载体转染至C3H10T1/2细胞模型,采用qPCR方法量化了增殖和成脂分化关键基因的表达水平变化,利用EdU染色检测细胞增殖活力,油红O染色方法鉴定脂滴积累的状态;进一步通过String database、Bio GRID、Int Act、GeneMANIA、DAVID和Genecard数据库构建Smdt1蛋白互作网络图。结果显示,在C3H10T1/2细胞中过表达Smdt1,极显著提升了增殖标志基因Pcna、Ki67、Cdk1及Cdk4的表达,EdU阳性细胞比例反映了细胞增殖速率加快;Smdt1极显著促进成脂分化关键基因Pparγ、Fabp4、-Adipoq的表达量,显著促进了Cebpα、Cebpβ的表达量,脂滴数量变多。在C3H10T1/2细胞体系中,干扰Smdt1,与增殖紧密相关的标志基因,包括Ki67、Pcna及Cdk1,其表达水平极显著降低,Cdk4的表达也呈现显著降低的趋势,反映在EdU增殖检测中,阳性细胞数量明显减少,细胞增殖活性受到抑制。进一步干扰Smdt1后,成脂分化途径的关键调控基因Cebpα、Pparγ、Cebpβ、Fabp4、Adipoq的表达均极显著降低,细胞内脂滴的数量也显著减少,细胞成脂分化能力削弱。蛋白功能预测发现,Smdt1能够与Mcu相互作用,参与线粒体钙离子转运、摄取和稳态。本研究发现Smdt1可以促进C3H10T1/2细胞增殖和成脂分化,为脂肪沉积的研究提供了新的方向。
