Autoantibodies in haemolytic uraemic syndrome (HUS)

Christine Skerka; Mihály Józsi; Peter F. Zipfel; Marie-Agnes Dragon-Durey; Veronique Fremeaux-Bacchi

doi:10.1160/TH08-05-0322

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2009; 101(02): 227-232
DOI: 10.1160/TH08-05-0322

Theme Issue Article

Schattauer GmbH

Autoantibodies in haemolytic uraemic syndrome (HUS)

Authors

Christine Skerka

¹Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Jena, Germany
Mihály Józsi

²Junior Research Group Cellular Immunobiology, Leibniz Institute for Natural Product Research and Infection Biology, Jena, Germany
Peter F. Zipfel

¹Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Jena, Germany

³Friedrich Schiller University, Jena, Germany
Marie-Agnes Dragon-Durey

⁴Department of Nephrology, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France
Veronique Fremeaux-Bacchi

⁴Department of Nephrology, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France

Abstract

Summary

Haemolytic uraemic syndrome (HUS) is a severe disease with renal failure, microangiopathic anemia and thrombocytopenia. Several mechanisms leading to HUS have been identified, like infections with enterohaemorrhagic Escherichia coli, as well as genetic mutations of complement genes, which result in defective complement control on the surface of host cells. The complement system forms the first defense line of innate immunity and mediates the attack against foreign microorganisms. Defective regulation of this cascade results in attack of self cells and in autoimmune disease. Apparently, the alternative pathway convertase C3bBb is central for the pathophysiology of HUS as gene mutations of the components (C3 and Factor B) or of regulators (Factor H, Factor I and MCP/CD46) are observed in the genetic form of HUS. Recently, a novel mechanism leading to atypical HUS (aHUS) was identified, in form of autoantibodies that bind the complement inhibitor Factor H. Here we summarize the current concept of HUS and focus in particular on the novel subgroup of aHUS patients with IgG autoantibodies to Factor H which develop on the genetic background of CFHR1/CFHR3 deficiency, and which define a new subform termed DEAP-HUS (deficient for CFHR proteins and Factor H autoantibody positive).

Keywords

Autoimmune diseases - immunity - thrombocytopenia - thrombosis - thrombotic thrombocytopenic purpura (TTP / HUS)

Full Text

References

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