Ng, Tsz Kin. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 151-185). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

The complement system is a major component of innate immunity and an effector of antibody-mediated immune responses. Unlike the other two activation pathways of the complement system, the alternative pathway is permanently switched on. Discrimination by complement between self and foreign is therefore achieved by selective protection of healthy host tissue and cells. This study investigated the alternative pathway regulator factor H (FH), which is crucial for protection of self surfaces from complement. FH engages via its N- and C- terminal ends with activation-specific fragments of C3, C3b and C3d. The middle region of FH has no binding sites for complement components. It presumably ensures that the binding sites at either end of the extended and flexible FH molecule cooperate in recognizing C3b in fluid phase or on self surfaces, but not on foreign targets. This study was aimed at achieving an atomic level understanding of the structure of the middle portion of FH, thereby testing hypotheses as to how it promotes the overall biological efficacy of the intact protein. High-resolution NMR-derived structures of two module pairs FH-10-11 and FH-11-12 were solved and combined with SAXS data to produce a model of FH-10-12. This was combined, in silico, with the previously solved FH-12-13 structure, then the model of FH-10-13 was used to revisit SAXS data for FH-10-15 and FH-8-15. A unique structure emerged, unlike any other encountered previously in the family of complement regulators, in which CCPs 13, 14 and 15 have a highly compacted organization that has repercussions for function. While devoid of binding affinity for host ligands, this central region is a binding site for PspC, a virulence factor of S. pneumoniae. It has been speculated that the bacteria use this interaction to sequester FH in a conformation that resembles the one adopted by FH on self cells and makes it particularly good at regulating complement. Structural and functional investigations of this interaction were performed to establish the molecular basis of the use of FH by this pathogen in order to avoid complement-mediated elimination. It was found that PspC and FH form a near-irreversible complex, while FH-8-15 binds PspC almost as tightly as intact protein. When bound to PspC, FH has a higher affinity for some of its targets, supporting the theory that this bacterial protein stabiles a particularly active conformation of the regulator.

C3 glomerulopathy (C3G) encompasses a group of severe renal diseases characterized by “dominant C3” deposition in the renal glomerulus. Patients typically present as nephritic nephrotics, with hematuria, hypertension, heavy proteinuria and edema. Within ten years of diagnosis, 50% of affected patients progress to end-stage renal disease and require dialysis or renal transplantation. No treatment is available to halt disease progression and thus both disease recurrence and allograft loss are common after transplantation. Genetic studies of C3G have firmly implicated dysregulation of the alternative pathway (AP) of complement in disease pathogenesis. In addition to genetic factors, acquired factors like autoantibodies can also exaggerate AP activity in the circulation to cause C3G. Although AP dysregulation in the circulation (i.e. fluid-phase dysregulation) has been well studied in these patients, AP activity in the glomerular microenvironment is not well understood. In this body of work, we used MaxGel, an ex-vivo surrogate for the glomerular extracellular matrix, to study AP activity and regulation. We showed that C3 convertase can be assembled on MaxGel and elucidated the dynamics of its formation and decay in the presence of complement regulators. We confirm that on MaxGel factor H (fH) inhibits C3 convertase formation and accelerates its decay, while properdin has a stabilizing effect. We also show that the complement factor H-related proteins (FHRs) are vital to the regulation of AP activity. Consistent with our MaxGel data, CFHR gene-fusion events have been reported as genetic drivers of disease in a few familial cases of C3G. One such familial case in which we identified and characterized the rearrangement event results from a novel CFHR5-CFHR2 fusion gene. The fusion gene is translated into a circulating FHR-5/-2 protein that consists of the first two SCRs of FHR-5 followed by all four SCRs of FHR-2. The structural repetition of SCR1-2 followed by another SCR1-2 motif facilitates the formation of complex FHR-1, FHR-2 and FHR-5 multimers, which have enhanced affinity for C3b and by out-competing fH, lead to impaired C3 convertase regulation in the glomerular microenvironment. Finally, we tested gene therapy as a tool to rescue the disease phenotype and restore fluid-phase AP complement control in a mouse model of C3G (Cfh-/-/huCR1-Tg mice). Using the piggyBac transposon system, we introduced a construct derived from complement regulator 1 (CR1) into Cfh-/-/huCR1-Tg mice. Delivery of sCR1-AC via hydrodynamic tail vein injection provided constitutive circulatory expression of sCR1-AC, and in animals followed for 6 months, we found that long-term expression of this complement regulator rescued the renal phenotype. These results suggest that sCR1 may be a potential therapy for patients with this disease.

The complement system plays an important role in innate and adaptive immunity. Central to all complement activities is the function of complement component 3 (C3). C3 contains a C-terminal extension of ~150 residues known as the NTR (or C345C) domain. To address the role of the NTR domain in binding and functional activities of C3, a C3/C5 chimera was engineered, in which the NTR domain of C3 was replaced by the homologous domain of the closely related protein C5. Functionally, the C3(C5NTR) was devoid of classical pathway-dependent hemolytic activity and deficient in factor H- and CR1-dependent factor I cleavability. Direct binding SPR assays, using chip bound methylamine treated His6-tagged C3(C5NTR), showed a complete loss of C5 binding while retaining wild type binding with CR1, factor H and factor B. These results present the first evidence for a major C5 binding site within C3 NTR.

The complement system plays an important role in innate and adaptive immunity. Central to all complement activities is the function of complement component 3 (C3). C3 contains a C-terminal extension of ~150 residues known as the NTR (or C345C) domain. To address the role of the NTR domain in binding and functional activities of C3, a C3/C5 chimera was engineered, in which the NTR domain of C3 was replaced by the homologous domain of the closely related protein C5. Functionally, the C3(C5NTR) was devoid of classical pathway-dependent hemolytic activity and deficient in factor H- and CR1-dependent factor I cleavability. Direct binding SPR assays, using chip bound methylamine treated His6-tagged C3(C5NTR), showed a complete loss of C5 binding while retaining wild type binding with CR1, factor H and factor B. These results present the first evidence for a major C5 binding site within C3 NTR.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-06, page: 3221. Adviser: Eric Boerwinkle. Includes bibliographical references.

O paciente, um menino brasileiro de família japonesa e pais consagüíneos, é portador de deficiência concomitante de C9 (C9D) e Fator (F) H. Detectamos níveis reduzidos de FH (16,8µg/mL), C3 e FB no seu soro. O Western Blot confirmou a ausência da proteína de 150 kDa (FH). Sua mãe também apresentou níveis reduzidos de FH (140,5µg/mL), C3 e FB, enquanto o pai e a irmã apresentaram níveis reduzidos de FH. C9 também estava reduzido no soro do paciente (5,6µg/mL). O seqüenciamento do cDNA de FH do paciente revelou a presença de uma substituição homozigota G453A, codificando uma His127Arg. Esta substituição é também homozigota na mãe e provavelmente altera a estrutura terciária do FH e/ou seu perfil de secreção, uma vez que o FH é produzido pelos fibroblastos do paciente. O seqüenciamento de fragmentos do DNA genômico de C9 do paciente revelou a ausência da mutação Arg95, principal causa de C9D entre japoneses. O paciente é portador de uma mutação missense que possivelmente impede a secreção de FH, contudo, não pudemos identificar mutações envolvidas na C9D do paciente. / Our proband, Brazilian from a family of Japanese descent and history of consanguinity, carries C9 (C9D) and FH deficiencies. He was referred with severe recurrent pneumonia. FH (16,8 µg/mL), C3 and FB were present in the patient at low levels. Western blot assays confirmed the complete absence of 150 kDa (FH). His mother also had FH (140,5 µg/mL), C3 and FB low levels, while his father and sister presented only FH low levels. C9 was present in low levels (5,6 µg/mL) and only a very faint ~70 kDa band (expected size) was detected. Sequencing of proband?s FH cDNA revealed a homozygous G453A substitution, encoding a His127Arg. This substitution is also homozygous in the mother and may alter FH protein tertiary structure and/or its secretion profile, as we detected FH production in patient?s fibroblast. Sequencing of proband?s C9 genomic DNA fragments revealed the absence of Arg95 mutation, main cause of C9D in other C9D Japanese patients. The proband carries a missense mutation that may impair the FH secretion, but we couldn?t identify mutations explaining its C9D.

A properdina tem a capacidade de estabilizar o complexo enzimático C3bBb, com função de C3-convertase da Via Alternativa, capaz de clivar moléculas de C3, gerando C3a e C3b. Diferentes trabalhos têm sugerido que a properdina pode se ligar diretamente à superficie de um patógeno independentemente complexo enzimático C3bBb. No que diz respeito à interação de properdina com Leptospira tanto patogênica quanto não patogênica, nada se conhece na literatura. Neste trabalho demostramos que tanto a properdina presente no SHN, quanto purificada e todos os seus oligômeros interagiram com tais espiroquetas. Também observamos que a ligação da properdina pode acontecer diretamente na superfície da bactéria ou após ligação prévia do fragmento C3b. Observamos também, que na presença de SHN estas bactérias foram totalmente eliminadas, no entanto, 70% das bactérias sobreviveram quando incubadas com SHD-P. Já a adição de properdina purificada ao SHD-P provoca uma marcante diminuição no número de leptospiras viáveis. Avaliamos também quais proteínas bacterianas teriam a capacidade de se ligar à properdina. Entre as proteínas recombinantes de L. interrogans, apenas a lipoproteína LIC11087, uma proteína presente unicamente na superfície de leptospiras patogênicas, interagiu com a properdina. Todos os oligômeros de properdina presentes no SHN interagiram com a lipoproteína LIC11087. Determinamos por quantificação do complexo enzimático usando anti-Factor B policlonal que a properdina apresenta uma significativa atividade reguladora quando se depositava na superfície das bactérias não patogênicas, promovendo desta maneira, a formação da C3-convertase da Via Alternativa. Constatamos também nos sorovares patogênicos, pouca atividade reguladora pela properdina quando estas leptospiras foram pré-incubadas com a proteína. Também encontramos que a ligação da properdina na superfície de leptospiras contribui para um aumento da fagocitose por polimorfonucleares humanos de leptospiras, principalmente das não patogênicas. Nossos dados obtidos até o momento sugerem que a properdina liga-se na superfície das leptospiras patogênicas e não patogênicas; participa no processo de eliminação de leptospiras não patogênicas pela Via Alternativa; e, após sua deposição na superfície das bactérias, contribui para a formação de uma C3-convertase nas bactérias não patogênicas, diferente ao modelo tradicional. / Properdin is a positive regulatory protein that stabilizes the C3- and C5-convertases of the alternative pathway. Several studies have suggested that properdin can bind directly to the surface of a pathogen regardless enzyme complex C3bBb. With regard to the interaction of properdin with both pathogenic Leptospira and non-pathogenic, nothing is known in the literature. In this work we demonstrate that both properdin present in SHN and purified and all their oligomers interacted with spirochetes and of properdin can binding directly on the surface of bacteria or after prior binding of C3b fragment. We also observed that the Activation of the alternative pathway of complement is crucial for killing non-pathogenic L. biflexa and properdin acts effectively since this bacterium proliferates in P-depleted human serum. Since the addition of purified properdin the SHD-P causes a marked decrease in the number of viable leptospires. We also evaluated bacterial proteins which have the ability to bind to properdin. Among several recombinant leptospiral membrane proteins tested, lipoprotein LIC11087, present only in pathogenic Leptospira, was the ligand for P, P2, P3 and P4. Determined by quantifying the enzyme complex using polyclonal anti-factor B that properdin presents a significant regulatory activity when deposited on the surface of non-pathogenic bacteria, thereby promoting the formation of C3 convertase Alternative pathway. We found also in pathogenic serovars, little regulatory activity by properdin when they were preincubated leptospires with the protein. We also found that the binding of properdin in leptospiras surface contributes to increased phagocytosis of leptospira by human polymorphonuclear, mainly from non-pathogenic. Our data obtained suggest that properdin binds to Leptospira species and may play an important role to limit the proliferation of non-pathogenic Leptospira; participates in leptospiras elimination process nonpathogenic Via Alternative; and, after deposition on the surface of bacteria, it contributes to the formation of a C3 convertase in non-pathogenic bacteria, different from the traditional model.

Orientador: José Paulo Cabral de Vasconcellos / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T03:32:34Z (GMT). No. of bitstreams: 1 Medina_FlavioMacCord_D.pdf: 2571030 bytes, checksum: 442e6e86f7bd3a0d6fae088740a1e85e (MD5) Previous issue date: 2013 / Resumo: Introdução: O fator de complemento H (CFH) é um componente do sistema imunológico que possui ação imunomoduladora sobre a resposta inflamatória. A gravidade da degeneração macular relacionada à idade (DMRI) é determinada em parte por um estado inflamatório sustentado por atividade aberrante da via alternativa do complemento. As evidências na literatura da relação entre o polimorfismo Y402H do gene CFH e a resposta ao tratamento da DMRI exsudativa permanecem controversas. Objetivo: Avaliar a associação entre as variantes do polimorfismo Y402H do gene CFH e os efeitos funcional e morfológico a curto prazo, assim como a evolução a longo prazo, dos antiangiogênicos em pacientes com DMRI exsudativa. Métodos: Vinte e cinco pacientes recém diagnosticados com DMRI exsudativa foram avaliados em um estudo de curto prazo com acuidade visual medida pela tabela do ETDRS e espessura retiniana central por tomografia de coerência óptica (OCT) de alta resolução, submetidos a injeção intravítrea de bevacizumabe e prospectivamente reexaminados em 7 e 28 dias. Quarenta e seis pacientes previamente submetidos ao tratamento com antiangiogênicos tiveram seus prontuários e exames retrospectivamente avaliados em um estudo de longo prazo quanto às evoluções funcional e morfológica ao longo de um ano. Esses parâmetros foram comparados com o genótipo do CFH, cuja análise molecular do polimorfismo Y402H foi realizada por meio da reação em cadeia da polimerase (PCR) e sequenciamento direto. Resultados: No estudo de curto prazo, houve melhora da acuidade visual no dia 28 em relação ao valor inicial (D0 vs. D28) em todos os genótipos. Entretanto, no grupo homozigoto para o alelo de risco (CC), ocorreu diferença apenas no dia 28 em relação ao dia 7 (D7 vs. D28), enquanto nos grupos CT e TT, a acuidade visual melhorou mais precocemente, no dia 7 em relação ao valor inicial (D0 vs. D7). A espessura retiniana central apresentou redução nos grupos CT (D0 vs. D7 e D0 vs. D28) e TT (D0 vs. D28), enquanto não houve mudança significativa no grupo CC. No estudo de longo prazo, foi evidenciada melhora da acuidade visual ao longo de um ano de acompanhamento apenas no grupo de pacientes sem o alelo C, sem diferença significativa no grupo de pacientes com o alelo de risco. A espessura retiniana central apresentou redução nos genótipos CT e TT, enquanto que no grupo CC não houve significância. Número de injeções, persistência de atividade neovascular e percepção subjetiva de melhora não diferiram entre os genótipos. Conclusão: O perfil de genótipo do CFH parece influenciar o efeito funcional e morfológico da injeção intravítrea de bevacizumabe com uma ação mais precoce em pacientes sem o genótipo de risco. A presença do alelo de risco parece estar relacionada à ausência de melhora visual ao longo de um ano de tratamento com inibidores do VEGF. Esses resultados sugerem que o perfil do genótipo do CFH possa exercer efeito farmacogenético nesse grupo de pacientes brasileiros, influenciando negativamente a resposta ao tratamento da DMRI exsudativa com antiangiogênicos / Abstract: Introduction: The complement factor H (CFH) is a component of the immune system that has immunomodulatory action on the inflammatory response. The severity of age-related macular degeneration (AMD) is determined in part by an inflammatory state sustained by aberrant activity of the alternative complement pathway. Evidences in the literature of the relationship between the Y402H polymorphism of CFH gene and response to treatment of wet AMD remain controversial. Purpose: To evaluate the association between variants of the Y402H polymorphism of CFH gene polymorphism and the short-term functional and morphological effects, as well as long-term evolution, of antiangiogenic drugs in patients with exudative AMD. Methods: Twenty-five patients with newly diagnosed exudative AMD were evaluated in a short-term study with visual acuity on ETDRS chart and central retinal thickness measured with high resolution optical coherence tomography (OCT), underwent intravitreal injection of bevacizumab and were prospectively reviewed in 7 and 28 days. Forty-six patients previously submitted to treatment with VEGF inhibitors had their medical charts retrospectively evaluated in a long-term study about the functional and morphological evolutions over one year. These parameters were compared with the CFH genotype, whose molecular analysis of Y402H polymorphism was performed by polymerase chain reaction (PCR) and direct sequencing. Results: In the short-term study, there was improvement in visual acuity at day 28 compared to baseline (D0 vs. D28) in all genotypes. However, in the group homozygous for the risk allele (CC), differences occurred only on day 28 compared to day 7 (D7 vs. D28), while the CT and TT groups, visual acuity improved earlier in the day 7 compared the initial value (D0 vs. D7). The central retinal thickness decreased in groups CT (D0 vs. D7, D0 vs. D28) and TT (D0 vs. D28), while there was no significant change in group CC. In the long-term study, it was noticed improvement in visual acuity over one year of follow-up in the group of patients without the C allele and no significant difference in the group of patients with the risk allele. The central retinal thickness decreased in the CT and TT genotypes, whereas in the CC group the difference was not significant. Number of injections, persistent neovascular activity and subjective perception of improvement did not differ between genotypes. Conclusion: The profile of the CFH genotype seems to influence the functional and morphological effect of intravitreal injection of bevacizumab with an earlier action in patients without the risk genotype. The presence of the risk allele seems to be related to the lack of visual improvement over one year of treatment with inhibitors of VEGF. These results suggest that the profile of the CFH genotype may present pharmacogenetic effect in this group of Brazilian patients, negatively influencing the response to treatment of exudative AMD with antiangiogenic drugs / Doutorado / Oftalmologia / Doutor em Ciências Médicas

The brain and spinal cord make up the central nervous system (CNS), and as an immune-privileged site, it requires special immune surveillance and regulation. The complement system is a component of innate immunity produced locally in the CNS, since size restrictions from the blood brain barrier prevent complement proteins from easily passing through from the rest of the body. The complement pathway contributes to inflammatory cell recruitment, cell lysis, and opsonization, and thus requires regulation to avoid inappropriate activation. Despite its important role in innate immunity, very little is known about complement production, regulation, and function in the CNS of healthy or diseased individuals. For this dissertation, the central goal was to investigate and characterize the regulation of complement factor H (CFH), a regulator of the alternative pathway of complement activation. CFH polymorphisms have been associated with a number of diseases including atypical hemolytic syndrome, age-related macular degeneration, and Alzheimer's disease, but the regulation of CFH is not well understood, especially in the CNS. To investigate the role of CFH in the CNS, mRNA and protein production in glial cells was first established. The murine CFH (mCFH) promoter was cloned and the transcription start site was identified in astrocytes, microglia, and liver tissue. The mCFH promoter was truncated and different regions were investigated for enhancer or silencer activity. Database mining identified potential transcription factor binding sites, and mutagenesis studies and binding assays identified transcription factor binding candidates. Specifically, the activating protein-1 (AP-1) transcription factors c-Jun and c-Fos bound to a region of the mCFH promoter between – 416 base pairs (bp) and – 175 bp in an electrophoretic mobility supershift assay. Cytokine stimulation increased mCFH mRNA and protein production, as well as the mRNA production of c-Jun and c-Fos and the protein production of c-Jun. These results suggest a relationship between cell cycle and complement regulation, and the investigation of how these transcription factors and CFH affect disease will be a valuable area of research for CNS immune regulation.