Systemic Complement Activation in Age-Related Macular Degeneration

Dysregulation of the alternative pathway (AP) of complement cascade has been implicated in the pathogenesis of age-related macular degeneration (AMD), the leading cause of blindness in the elderly. To further test the hypothesis that defective control of complement activation underlies AMD, paramete...

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Published inPloS one Vol. 3; no. 7; p. e2593
Main Authors Scholl, Hendrik P. N., Issa, Peter Charbel, Walier, Maja, Janzer, Stefanie, Pollok-Kopp, Beatrix, Börncke, Florian, Fritsche, Lars G., Chong, Ngaihang V., Fimmers, Rolf, Wienker, Thomas, Holz, Frank G., Weber, Bernhard H. F., Oppermann, Martin
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 02.07.2008
Public Library of Science (PLoS)
Subjects
Online AccessGet full text
ISSN1932-6203
1932-6203
DOI10.1371/journal.pone.0002593

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Abstract Dysregulation of the alternative pathway (AP) of complement cascade has been implicated in the pathogenesis of age-related macular degeneration (AMD), the leading cause of blindness in the elderly. To further test the hypothesis that defective control of complement activation underlies AMD, parameters of complement activation in blood plasma were determined together with disease-associated genetic markers in AMD patients. Plasma concentrations of activation products C3d, Ba, C3a, C5a, SC5b-9, substrate proteins C3, C4, factor B and regulators factor H and factor D were quantified in patients (n = 112) and controls (n = 67). Subjects were analyzed for single nucleotide polymorphisms in factor H (CFH), factor B-C2 (BF-C2) and complement C3 (C3) genes which were previously found to be associated with AMD. All activation products, especially markers of chronic complement activation Ba and C3d (p<0.001), were significantly elevated in AMD patients compared to controls. Similar alterations were observed in factor D, but not in C3, C4 or factor H. Logistic regression analysis revealed better discriminative accuracy of a model that is based only on complement activation markers Ba, C3d and factor D compared to a model based on genetic markers of the complement system within our study population. In both the controls' and AMD patients' group, the protein markers of complement activation were correlated with CFH haplotypes.This study is the first to show systemic complement activation in AMD patients. This suggests that AMD is a systemic disease with local disease manifestation at the ageing macula. Furthermore, the data provide evidence for an association of systemic activation of the alternative complement pathway with genetic variants of CFH that were previously linked to AMD susceptibility.
AbstractList Dysregulation of the alternative pathway (AP) of complement cascade has been implicated in the pathogenesis of age-related macular degeneration (AMD), the leading cause of blindness in the elderly. To further test the hypothesis that defective control of complement activation underlies AMD, parameters of complement activation in blood plasma were determined together with disease-associated genetic markers in AMD patients. Plasma concentrations of activation products C3d, Ba, C3a, C5a, SC5b-9, substrate proteins C3, C4, factor B and regulators factor H and factor D were quantified in patients (n = 112) and controls (n = 67). Subjects were analyzed for single nucleotide polymorphisms in factor H (CFH), factor B-C2 (BF-C2) and complement C3 (C3) genes which were previously found to be associated with AMD. All activation products, especially markers of chronic complement activation Ba and C3d (p<0.001), were significantly elevated in AMD patients compared to controls. Similar alterations were observed in factor D, but not in C3, C4 or factor H. Logistic regression analysis revealed better discriminative accuracy of a model that is based only on complement activation markers Ba, C3d and factor D compared to a model based on genetic markers of the complement system within our study population. In both the controls' and AMD patients' group, the protein markers of complement activation were correlated with CFH haplotypes. This study is the first to show systemic complement activation in AMD patients. This suggests that AMD is a systemic disease with local disease manifestation at the ageing macula. Furthermore, the data provide evidence for an association of systemic activation of the alternative complement pathway with genetic variants of CFH that were previously linked to AMD susceptibility.
Dysregulation of the alternative pathway (AP) of complement cascade has been implicated in the pathogenesis of age-related macular degeneration (AMD), the leading cause of blindness in the elderly. To further test the hypothesis that defective control of complement activation underlies AMD, parameters of complement activation in blood plasma were determined together with disease-associated genetic markers in AMD patients. Plasma concentrations of activation products C3d, Ba, C3a, C5a, SC5b-9, substrate proteins C3, C4, factor B and regulators factor H and factor D were quantified in patients (n = 112) and controls (n = 67). Subjects were analyzed for single nucleotide polymorphisms in factor H (CFH), factor B-C2 (BF-C2) and complement C3 (C3) genes which were previously found to be associated with AMD. All activation products, especially markers of chronic complement activation Ba and C3d (p<0.001), were significantly elevated in AMD patients compared to controls. Similar alterations were observed in factor D, but not in C3, C4 or factor H. Logistic regression analysis revealed better discriminative accuracy of a model that is based only on complement activation markers Ba, C3d and factor D compared to a model based on genetic markers of the complement system within our study population. In both the controls' and AMD patients' group, the protein markers of complement activation were correlated with CFH haplotypes. This study is the first to show systemic complement activation in AMD patients. This suggests that AMD is a systemic disease with local disease manifestation at the ageing macula. Furthermore, the data provide evidence for an association of systemic activation of the alternative complement pathway with genetic variants of CFH that were previously linked to AMD susceptibility.
Dysregulation of the alternative pathway (AP) of complement cascade has been implicated in the pathogenesis of age-related macular degeneration (AMD), the leading cause of blindness in the elderly. To further test the hypothesis that defective control of complement activation underlies AMD, parameters of complement activation in blood plasma were determined together with disease-associated genetic markers in AMD patients. Plasma concentrations of activation products C3d, Ba, C3a, C5a, SC5b-9, substrate proteins C3, C4, factor B and regulators factor H and factor D were quantified in patients (n = 112) and controls (n = 67). Subjects were analyzed for single nucleotide polymorphisms in factor H (CFH), factor B-C2 (BF-C2) and complement C3 (C3) genes which were previously found to be associated with AMD. All activation products, especially markers of chronic complement activation Ba and C3d (p<0.001), were significantly elevated in AMD patients compared to controls. Similar alterations were observed in factor D, but not in C3, C4 or factor H. Logistic regression analysis revealed better discriminative accuracy of a model that is based only on complement activation markers Ba, C3d and factor D compared to a model based on genetic markers of the complement system within our study population. In both the controls' and AMD patients' group, the protein markers of complement activation were correlated with CFH haplotypes.
Dysregulation of the alternative pathway (AP) of complement cascade has been implicated in the pathogenesis of age-related macular degeneration (AMD), the leading cause of blindness in the elderly. To further test the hypothesis that defective control of complement activation underlies AMD, parameters of complement activation in blood plasma were determined together with disease-associated genetic markers in AMD patients. Plasma concentrations of activation products C3d, Ba, C3a, C5a, SC5b-9, substrate proteins C3, C4, factor B and regulators factor H and factor D were quantified in patients (n = 112) and controls (n = 67). Subjects were analyzed for single nucleotide polymorphisms in factor H (CFH), factor B-C2 (BF-C2) and complement C3 (C3) genes which were previously found to be associated with AMD. All activation products, especially markers of chronic complement activation Ba and C3d (p<0.001), were significantly elevated in AMD patients compared to controls. Similar alterations were observed in factor D, but not in C3, C4 or factor H. Logistic regression analysis revealed better discriminative accuracy of a model that is based only on complement activation markers Ba, C3d and factor D compared to a model based on genetic markers of the complement system within our study population. In both the controls' and AMD patients' group, the protein markers of complement activation were correlated with CFH haplotypes.This study is the first to show systemic complement activation in AMD patients. This suggests that AMD is a systemic disease with local disease manifestation at the ageing macula. Furthermore, the data provide evidence for an association of systemic activation of the alternative complement pathway with genetic variants of CFH that were previously linked to AMD susceptibility.Dysregulation of the alternative pathway (AP) of complement cascade has been implicated in the pathogenesis of age-related macular degeneration (AMD), the leading cause of blindness in the elderly. To further test the hypothesis that defective control of complement activation underlies AMD, parameters of complement activation in blood plasma were determined together with disease-associated genetic markers in AMD patients. Plasma concentrations of activation products C3d, Ba, C3a, C5a, SC5b-9, substrate proteins C3, C4, factor B and regulators factor H and factor D were quantified in patients (n = 112) and controls (n = 67). Subjects were analyzed for single nucleotide polymorphisms in factor H (CFH), factor B-C2 (BF-C2) and complement C3 (C3) genes which were previously found to be associated with AMD. All activation products, especially markers of chronic complement activation Ba and C3d (p<0.001), were significantly elevated in AMD patients compared to controls. Similar alterations were observed in factor D, but not in C3, C4 or factor H. Logistic regression analysis revealed better discriminative accuracy of a model that is based only on complement activation markers Ba, C3d and factor D compared to a model based on genetic markers of the complement system within our study population. In both the controls' and AMD patients' group, the protein markers of complement activation were correlated with CFH haplotypes.This study is the first to show systemic complement activation in AMD patients. This suggests that AMD is a systemic disease with local disease manifestation at the ageing macula. Furthermore, the data provide evidence for an association of systemic activation of the alternative complement pathway with genetic variants of CFH that were previously linked to AMD susceptibility.
Dysregulation of the alternative pathway (AP) of complement cascade has been implicated in the pathogenesis of age-related macular degeneration (AMD), the leading cause of blindness in the elderly. To further test the hypothesis that defective control of complement activation underlies AMD, parameters of complement activation in blood plasma were determined together with disease-associated genetic markers in AMD patients. Plasma concentrations of activation products C3d, Ba, C3a, C5a, SC5b-9, substrate proteins C3, C4, factor B and regulators factor H and factor D were quantified in patients (n = 112) and controls (n = 67). Subjects were analyzed for single nucleotide polymorphisms in factor H ( CFH ), factor B-C2 ( BF-C2 ) and complement C3 ( C3 ) genes which were previously found to be associated with AMD. All activation products, especially markers of chronic complement activation Ba and C3d (p<0.001), were significantly elevated in AMD patients compared to controls. Similar alterations were observed in factor D, but not in C3, C4 or factor H. Logistic regression analysis revealed better discriminative accuracy of a model that is based only on complement activation markers Ba, C3d and factor D compared to a model based on genetic markers of the complement system within our study population. In both the controls' and AMD patients' group, the protein markers of complement activation were correlated with CFH haplotypes. This study is the first to show systemic complement activation in AMD patients. This suggests that AMD is a systemic disease with local disease manifestation at the ageing macula. Furthermore, the data provide evidence for an association of systemic activation of the alternative complement pathway with genetic variants of CFH that were previously linked to AMD susceptibility.
Audience Academic
Author Weber, Bernhard H. F.
Fritsche, Lars G.
Fimmers, Rolf
Wienker, Thomas
Scholl, Hendrik P. N.
Börncke, Florian
Janzer, Stefanie
Chong, Ngaihang V.
Holz, Frank G.
Issa, Peter Charbel
Pollok-Kopp, Beatrix
Oppermann, Martin
Walier, Maja
AuthorAffiliation 3 Department of Cellular and Molecular Immunology, University of Göttingen, Göttingen, Germany
4 Institute of Human Genetics, University of Regensburg, Regensburg, Germany
Ohio State University Medical Center, United States of America
5 Oxford Eye Hospital, University of Oxford, Oxford, United Kingdom
1 Department of Ophthalmology, University of Bonn, Bonn, Germany
2 Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
AuthorAffiliation_xml – name: 3 Department of Cellular and Molecular Immunology, University of Göttingen, Göttingen, Germany
– name: 4 Institute of Human Genetics, University of Regensburg, Regensburg, Germany
– name: Ohio State University Medical Center, United States of America
– name: 2 Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
– name: 1 Department of Ophthalmology, University of Bonn, Bonn, Germany
– name: 5 Oxford Eye Hospital, University of Oxford, Oxford, United Kingdom
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  surname: Scholl
  fullname: Scholl, Hendrik P. N.
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  givenname: Peter Charbel
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  surname: Walier
  fullname: Walier, Maja
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  surname: Janzer
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  fullname: Börncke, Florian
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  givenname: Lars G.
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  fullname: Fritsche, Lars G.
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  surname: Chong
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– sequence: 13
  givenname: Martin
  surname: Oppermann
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/18596911$$D View this record in MEDLINE/PubMed
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Conceived and designed the experiments: MO HS NC TW BW. Performed the experiments: LF MO HS PI SJ BP FB. Analyzed the data: RF MW TW. Wrote the paper: LF RF MO HS PI MW SJ BP FB NC TW FH BW.
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Snippet Dysregulation of the alternative pathway (AP) of complement cascade has been implicated in the pathogenesis of age-related macular degeneration (AMD), the...
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StartPage e2593
SubjectTerms Age
Age related diseases
Aged
Aged, 80 and over
Alternative pathway
Anticoagulants
Biometrics
Blindness
Blood plasma
Case-Control Studies
Complement
Complement Activation
Complement component C2
Complement component C3
Complement component C3d
Complement component C4
Complement component C5a
Complement factor B
Complement factor H
Complement Factor H - genetics
Complement Factor H - metabolism
Correlation analysis
Digitization
Enzymes
Epidemiology
Female
Genes
Genetic aspects
Genetic diversity
Genetic markers
Genetic variance
Genetic Variation
Genetics and Genomics/Genetics of Disease
Genotype
Geriatrics
Haplotypes
Humans
Immunoassay
Immunology
Immunology/Innate Immunity
Informatics
Macular degeneration
Macular Degeneration - genetics
Macular Degeneration - immunology
Male
Markers
Older people
Ophthalmology/Inherited Eye Disorders
Ophthalmology/Macular Disorders
Pathogenesis
Patients
Physiological aspects
Plasma
Polymorphism, Single Nucleotide
Population studies
Proteins
Regression analysis
Regulators
Risk Factors
Single nucleotide polymorphisms
Single-nucleotide polymorphism
Studies
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Title Systemic Complement Activation in Age-Related Macular Degeneration
URI https://www.ncbi.nlm.nih.gov/pubmed/18596911
https://www.proquest.com/docview/1312314505
https://www.proquest.com/docview/21062433
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https://pubmed.ncbi.nlm.nih.gov/PMC2440421
https://doaj.org/article/54321e3b161340feb7ce15c45369cf16
http://dx.doi.org/10.1371/journal.pone.0002593
Volume 3
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