[go: up one dir, main page]
More Web Proxy on the site http://driver.im/

Plasma levels of complement activation fragments C3b and sC5b-9 significantly increased in patients with thrombotic microangiopathy after allogeneic stem cell transplantation

Ann Hematol. 2017 Nov;96(11):1849-1855. doi: 10.1007/s00277-017-3092-9. Epub 2017 Aug 11.

Abstract

Transplantation-associated thrombotic microangiopathy (TA-TMA) is an uncommon but severe complication in patients undergoing allogeneic stem cell transplantation (allo-SCT). However, the mechanism is unclear. From 2011 to 2014, 20 patients with TA-TMA, 20 patients without, and 54 patients with various other complications, including veno occlusive disease (VOD), graft-versus-host disease (GVHD), and infection, were recruited in the study. Plasma vWF antigen (vWFAg), vWF activity (vWFAc), and ADAMTS13 activity were determined in these patients by ELISAs and FRETS-vWF73 assay, respectively. Plasma C3b, sC5b-9, and CH50 were also determined by ELISAs. Plasma levels of C3b were significantly increased in patients with either TA-TMA (p < 0.0001) or GVHD (p < 0.01). Plasma sC5b-9 and CH50 levels in patients with TA-TMA were also significantly increased (p < 0.001). Plasma ADAMTS13 activity was lower in patients with VOD, but normal with other complications. Both plasma vWFAg and vWFAc levels were not elevated in patients with TA-TMA or VOD compared with those of other groups. Complement activation likely via an alternative pathway (increased C3b, sC5b-9, and CH50) may play a role in the pathogenesis of TA-TMA. ADAMTS13 activity is reduced in VOD, but the ADAMTS13/vWF axis appears to be unaffected in patients with TA-TMA.

Keywords: C3b; Complement activation; Stem cell transplantation; Transplantation-associated thrombotic microangiopathy; sC5b-9.

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Complement Activation / physiology*
  • Complement C3b / metabolism*
  • Complement Membrane Attack Complex / metabolism*
  • Female
  • Graft vs Host Disease / blood
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hematopoietic Stem Cell Transplantation / trends
  • Humans
  • Male
  • Thrombotic Microangiopathies / blood*
  • Thrombotic Microangiopathies / diagnosis
  • Thrombotic Microangiopathies / etiology*
  • Transplantation, Homologous / adverse effects
  • Transplantation, Homologous / trends
  • Young Adult

Substances

  • Biomarkers
  • Complement Membrane Attack Complex
  • SC5b-9 protein complex
  • Complement C3b