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Query: UMLS:C0024141 (
systemic lupus erythematosus
)
44,322
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The first inherited combined total deficiency of C7 and
C4B
complement components associated with
SLE
is described in a young female. Functional C7 assays showed a homozygous C7 deficiency in the propositus and her sister, and an heterozygous one in their parents. C4 molecular analyses showed that both the propositus and her mother had two HLA haplotypes carrying only C4A-specific DNA sequences and a normal C4 gene number. Thus, only C4A proteins could be expressed, with resultant normal C4 serum levels. The coexistence of a combined complete C7 and
C4B
deficiency may therefore abrogate essential functions of the complement cascade presumably related to immune complex handling and solubilization despite an excess of circulating C4A. These findings challenge the putative pathophysiological roles of C4A and
C4B
and stress the need to perform both functional assays and C4 allotyping in patients with autoimmune pathology and low haemolytic activity without low serum levels of a classical pathway complement component.
...
PMID:Combined total deficiency of C7 and C4B with systemic lupus erythematosus (SLE). 134 91
In a multicenter study more than 300 central European
systemic lupus erythematosus
(
SLE
) patients were examined for HLA-B, HLA-DR, and complement C4 phenotypes. For 174
SLE
patients MHC haplotypes were determined by family segregation analysis, and for 155 patients C4 gene deletions were determined by TaqI restriction fragment length polymorphism. Two haplotypes, B8-C4AQ0-C4B1-DR3 and B7-C4A3-C4B1-DR2, were identified as risk factors for
SLE
. These findings were confirmed by applying the haplotype frequency difference (HFD) method, which uses nontransmitted haplotypes from the family study as internal controls. Furthermore, only HLA-DR2, but not DR3, B7, or B8, was significantly increased in
SLE
patients independently of the two risk haplotypes. C4A gene deletions, but not silent C4AQ0 alleles, were increased in
SLE
patients and neither C4BQ0 alleles nor
C4B
gene deletions were increased. The observed frequencies of homozygosity and heterozygosity for the two haplotypes and the frequencies of homozygotes for C4AQ0 and C4A deletions did not differ from the expected values, indicating that the risk for
SLE
is conveyed by single allele effects. In conclusion, there are two MHC-linked susceptibility factors for Caucasian
SLE
patients carried by the haplotypes B7-DR2 and B8-DR3. The results argue against C4Q0 alleles being the decisive factors increasing susceptibility to
SLE
.
...
PMID:Major histocompatibility complex haplotypes and complement C4 alleles in systemic lupus erythematosus. Results of a multicenter study. 140 Oct 69
We examined 18 families with infants who had neonatal lupus erythematosus (NLE) syndrome to determine whether abnormalities in C4 phenotypes and genotypes were an additional risk factor for this syndrome. Fifteen of 18 mothers of infants with NLE (83%) had C4 null allotypes compared with 36% of population controls (p = less than .001). This increased frequency was due mainly to the presence of C4A null allotypes (11/18, 61%). C4 gene abnormalities, i.e., deletion or probable duplication, were present in 100% (16/16) of mothers of infants with NLE. The most common molecular genetic abnormality in mothers of infants with NLE in this study was deletion of C4A genes. Duplication of C4A and
C4B
loci was also commonly seen. Duplication of C4A genes was detected only in mothers of infants with complete congenital heart block (CCHB), and duplication of
C4B
was detected only in mothers of infants with dermatitis. No significant increase in C4A or
C4B
null allotypes or protein deficiencies was noted in mothers of infants with neonatal
lupus
when compared with anti-Ro(SS-A)-positive mothers delivered of clinically normal infants. Fathers of infants with NLE showed a trend toward increase in
C4B
null allotypes when compared with population controls (75%, 3/4, p = .06). The two infants with CCHB examined were
C4B
protein-deficient, in contrast to infants with
lupus
dermatitis, who had frequent
C4B
null allotypes but no
C4B
protein deficiency.
C4B
null allotypes were not seen in unaffected siblings of infants with NLE and in only 1 of 7 anti-Ro(SS-A)-positive mothers who delivered clinically normal infants. We conclude that inheritance of C4A null allotypes is not predictive of increased risk of neonatal
lupus
when present in anti-Ro(SS-A)-positive women. Examination of paternal and maternal C4 genes of additional infants with NLE, in particular those with CCHB, and of normal infants born to anti-Ro(SS-A)-positive mothers--and of the normal infants' parents--is required to determine if abnormal
C4B
genes are a critical factor rendering susceptibility to the NLE syndrome.
...
PMID:Neonatal lupus erythematosus syndrome: analysis of C4 allotypes and C4 genes in 18 families. 154 98
In 1982 we reported that among Caucasians with
systemic lupus erythematosus
(
SLE
) there is an increased frequency of C4A null. As this allele occurs on the HLA-A1,B8,BfS, C4AQO,B1,DR3 (8.1) supratype, we suggested this accounted for the reported association of B8 and DR3. Since then we have shown that many supratypes including 8.1 identify unique segments of DNA conserved from a common but remote ancestor. Many of these ancestral haplotypes (AH), including 8.1, carry disease genes and some bear C4 null. We have therefore tested the hypothesis that in
SLE
C4 null alleles are directly involved by examining (1) whether all or only some AH bearing C4 null alleles are increased, (2) whether C4 null is increased in all racial groups examined, and (3) whether C4 null is associated with the presence of antinuclear antibodies (ANA) in the absence of
SLE
. We performed HLA and complement allotyping on 62 Australian Caucasians and 9 Australian aborigines with
SLE
and on the 10 out of 133 healthy individuals with 7 or more international units of ANA. Our data confirm an association of C4A null in Australian Caucasians (gene frequency 0.30 versus 0.15 in controls) and show an increased frequency of
C4B
null in Australian aborigines (gene frequency 0.33 versus 0.22). A review of an extensive literature shows C4A and/or
C4B
null are increased in all racial groups examined. On the other hand, the HLA-A3,B7,BfS,C4A3,B1,DR2 (7.1) AH rather than C4 null is associated with ANA in health. Our data indicate that while C4 nulls contribute to MHC susceptibility, other genes are likely to be involved.
...
PMID:Major histocompatibility complex (MHC) complement deficiency, ancestral haplotypes and systemic lupus erythematosus (SLE): C4 deficiency explains some but not all of the influence of the MHC. 175 37
Deficiencies of early components of the classical complement pathway are known to be associated with
systemic lupus erythematosus
(
SLE
). C4 null alleles, C4A Q0 and
C4B
Q0, are prime candidates for the major histocompatibility complex associated factor which determines susceptibility to
SLE
. There is poor correlation, however, between the presence of low concentrations of C4 and possession of C4 null alleles, and thus the basis of the association between C4A Q0,
C4B
Q0 and
SLE
remains obscure. The possibility that activation of C4 may be related to the possession of C4 null alleles was examined. C4 phenotypes were investigated, and C4 concentration and activation were estimated in patients with
SLE
. C4 activation was determined by measuring the concentration of C4d--a split product of C4. Twenty five of 35 patients had C4 phenotypes which include null alleles. No association between low C4 concentrations and C4 null alleles was found, but a significant association between low C4d concentrations and C4 phenotypes including null alleles, particularly those with C4A Q0, was noted. No correlation between concentrations of C4 and C4d was found. These results show an influence of C4 null alleles on the activation of the C4 molecule, which is independent of the concentration of C4. The possession of silent genes coding for C4 null alleles might predispose to
SLE
by conditioning poor C4 activation, a critical event for the clearance of immune complexes mediated by the classical complement pathway.
...
PMID:Influence of C4 null alleles on C4 activation in systemic lupus erythematosus. 202 8
The molecular basis of complement component C4A deficiency in white U.S. and Mexican patients with
systemic lupus erythematosus
(
SLE
) was studied. Genomic DNA from
SLE
patients and non-
SLE
controls was analyzed for restriction fragments using HindIII and a 5' C4 cDNA probe. C4A gene deletion was recognized by the loss of a 15-kb restriction fragment and the appearance of a 8.5-kb fragment. Thirty-two selected U.S.
SLE
patients, 7 nonSLE controls, and 11 Mexican
SLE
patients and 9 relatives were studied. The deletion was recognized in all of the 14 HLA-B8;DR3
SLE
patients with a C4A protein deficiency. Two
SLE
patients with DR3 but without B8 also had this gene deletion. None of the 3 U.S.
SLE
nonDR3, C4A protein deficient patients nor 20 C4A protein deficient Mexican individuals (11
SLE
patients and 9 relatives; none had B8 and/or DR3) showed this deletion. Thus the C4A gene deletion failed to account for the C4A protein deficiency in all the nonDR3 Mexicans and in some U.S.
SLE
patients. To determine whether gene conversion at the C4A locus would encode a
C4B
-like protein and be responsible for the C4A protein deficiency (in nonDR3 patients), the C4d region of the gene was amplified by polymerase chain reaction and subjected to Nla IV digestion, and restriction fragment analysis was performed using a C4d region-specific probe. The resulting restriction fragment length polymorphism pattern revealed no changes in the isotype-specific region of the gene as characterized by C4A-specific 276- and 191-bp fragments in Dr3 or nonDR3 individuals. Thus, homoexpression of
C4B
at both loci was not responsible for C4A deficiency in nonDR3
SLE
patients without C4A gene deletion.
...
PMID:DR3 and nonDR3 associated complement component C4A deficiency in systemic lupus erythematosus. 204 37
There are two isotypes of C4--C4A and
C4B
--, encoded within the major histocompatibility complex with quite different properties. In this study we have compared purified C4A and
C4B
with regard to their ability to prevent immune complex precipitation and to enhance the binding of both preformed and nascent immune complexes to the receptor CR1 on red cells. C4A was modestly more effective than
C4B
at inhibiting immunoprecipitation, particularly in antibody excess. In the CR1 binding assay C4A was markedly more effective than
C4B
in enhancing binding to CR1. This difference was seen with both preformed and nascent immune complexes at equivalence and antibody excess. Thus the major differences between C4A and
C4B
in regard to immune complex handling is at the level of CR1 binding. Given the strong association of C4A* QO alleles with immune complex-mediated diseases like
systemic lupus erythematosus
, these findings have important pathogenetic implications.
...
PMID:Differences between C4A and C4B in the handling of immune complexes: the enhancement of CR1 binding is more important than the inhibition of immunoprecipitation. 213 67
Deficiencies in proteins of the classic complement pathway are particularly frequent in patients with autoimmune diseases, notably
systemic lupus erythematosus
(
SLE
). The C4 component is a polymorphous glucoprotein coded by two closely linked genes, C4A and
C4B
, located within the HLA complex. C4, and in particular the C4A isotype plays a major role in maintaining immune complexes in solution. Fifty percent of patients with
SLE
are homozygous or heterozygous to the silent allele C4 AQO. Hereditary CE deficiency is often complicated by
lupus
-related diseases which may be associated with repeated infections. The biological particularity of
SLE
associated with complement protein deficiencies is the frequency of anti-SSA (Ro) antibodies.
...
PMID:[Lupus and protein deficiencies of the classical complement pathway]. 223 85
Homozygous C4A deficiency was found at a prevalence of 16% (13/80 patients) in
systemic lupus erythematosus
(
SLE
). The patients represented all diagnosed cases retrieved from a defined population in Southern Sweden, which minimizes the influence of patient selection. Photosensitivity was more common among C4A-deficient patients than among other
SLE
patients (p less than 0.05). Otherwise, clinical features were similar in the two groups. In addition, no differences were found with regard to presence of various autoantibodies (anti-dsDNA, anti-Sm, anti-RNP, anti-SSA, anti-SSB, rheumatoid factors and anti-cardiolipin). In patients expressing both C4A and
C4B
isotypes,
C4B
/C4A quotients were fairly stable in plasma irrespective of disease activity. This argues against preferential break-down of either isotype during complement activation in the disease. The increased photosensitivity of C4A-deficient patients partly resembles the findings in patients with complete deficiencies of classical pathway components.
...
PMID:Homozygous C4A deficiency in systemic lupus erythematosus: analysis of patients from a defined population. 228 15
Previous studies of patients with
systemic lupus erythematosus
(
SLE
) have shown an increased frequency of certain major histocompatibility complex (MHC) markers, including HLA-DR2, DR3, and C4AQ0 (C4A-null), in Caucasian patients. However, most of these studies were of randomly selected, unrelated patients; families were not included, and haplotypes were not determined. In order to define more accurately the possible role of MHC genes in
lupus
susceptibility, HLA-A, B, C, and DR, as well as BF, C2, C4A,
C4B
, and GLO, markers were determined in 62 Caucasian patients of known ethnic background, and in the members of their families. The distributions of extended haplotypes (fixed combinations of HLA-B, DR, and complotype alleles), fragments thereof, and individual alleles were determined in
SLE
patients and controls. The MHC distributions in all patients were compared with haplotypes in a normal Caucasian population. There were no statistically significant differences between the frequencies of any MHC marker, fragment, or extended haplotype in the patients compared with the controls. The patients were categorized into 2 groups of European ancestry (English/Irish; other Europeans), and each group was compared with a group of ethnically matched controls. There was a statistically significantly increased frequency of the alleles C4AQ0 and DR3 and the complotype SC01 in
SLE
patients of English/Irish descent as compared with ethnically matched controls. The increase in C4AQ0 and DR3 could be accounted for by the fact that they were part of the extended haplotype [HLA-B8;SC01;DR3] and/or its fragment (SC01;DR3). No increase in any MHC marker was observed in the other patients.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:The effect of ethnicity on major histocompatibility complex complement allotypes and extended haplotypes in patients with systemic lupus erythematosus. 236 33
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