CIRCULATING IMMUNE COMPLEXES AND COMPLEMENT BREAKDOWN PRODUCT C3d IN GLOMERULONEPHRITIS AND KIDNEY TRANSPLANTATION

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Abstract
Circulating immune complexes (CIC) and the complement breakdown product C3d were measured in 81 patients with glomerulonephritis (GN), 28 patients with early and 25 patients with long-term renal transplants. CIC were measured by a Clq-binding assay and C3d by a double-decker rocket immunoelectrophoresis. In patients with GN, CIC were detected in 19 and elevated C3d levels found in 45 patients. The highest levels of C3d were found in patients with membranoproliferative GN type I and II, diffuse sclerosing GN and GN secondary to systemic lupus erythematosus and Wegener''s granulomatosis. No relationship was found between CIC and C3d, and the combination of CIC with C3d measurements did not help to characterize nephritogenic CIC. C3d was frequently elevated in patients with impaired renal function which may reflect an inflammatory nephritic process, but may also be due to a reduced renal elimination. C3d was frequently elevated in patients with improving or decreasing renal function, and in patients with heavy proteinuria. Longitudinal studies of renal transplant patients suggested that immunosuppressive treatment decreased the C3d level. Patients with early renal transplants had elevated C3d levels that normalized during the first month after successful transplantation. CIC and elevated C3d were not related to onset of acute rejection episodes in early transplant patients nor to late renal graft failure.