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. 1992 Mar;87(3):410–414. doi: 10.1111/j.1365-2249.1992.tb03011.x

Combined total deficiency of C7 and C4B with systemic lupus erythematosus (SLE).

O G Segurado 1, A A Arnaiz-Villena 1, P Iglesias-Casarrubios 1, J Martinez-Laso 1, J L Vicario 1, G Fontan 1, M Lopez-Trascasa 1
PMCID: PMC1554335  PMID: 1347491

Abstract

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.

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Selected References

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  1. Bishof N. A., Welch T. R., Beischel L. S. C4B deficiency: a risk factor for bacteremia with encapsulated organisms. J Infect Dis. 1990 Jul;162(1):248–250. doi: 10.1093/infdis/162.1.248. [DOI] [PubMed] [Google Scholar]
  2. Chapel H. M., Peto T. E., Luzzi G. A., Thompson R. A., Fielder A. H., Batchelor J. R. Combined familial C7 and C4B deficiency in an adult with meningococcal disease. Clin Exp Immunol. 1987 Jan;67(1):55–58. [PMC free article] [PubMed] [Google Scholar]
  3. Coleman T. H., Forristal J., Kosaka T., West C. D. Inherited complement component deficiencies in membranoproliferative glomerulonephritis. Kidney Int. 1983 Nov;24(5):681–690. doi: 10.1038/ki.1983.211. [DOI] [PubMed] [Google Scholar]
  4. Fasano M. B., Densen P., McLean R. H., Winkelstein J. A. Prevalence of homozygous C4B deficiency in patients with deficiencies of terminal complement components and meningococcemia. J Infect Dis. 1990 Nov;162(5):1220–1221. doi: 10.1093/infdis/162.5.1220. [DOI] [PubMed] [Google Scholar]
  5. Gatenby P. A., Barbosa J. E., Lachmann P. J. Differences between C4A and C4B in the handling of immune complexes: the enhancement of CR1 binding is more important than the inhibition of immunoprecipitation. Clin Exp Immunol. 1990 Feb;79(2):158–163. doi: 10.1111/j.1365-2249.1990.tb05172.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gianella-Borradori A., Borradori L., Schneider P. M., Gautier E., Späth P. J. Combined complete C5 and partial C4 deficiency in humans: clinical consequences and complement-mediated functions in vitro. Clin Immunol Immunopathol. 1990 Apr;55(1):41–55. doi: 10.1016/0090-1229(90)90067-z. [DOI] [PubMed] [Google Scholar]
  7. Gómez-Reino J. J., Martínez-Laso J., Vicario J. L., Paz-Artal E., Aragón A., Martín-Villa J. M., De Juan M. D., Pérez-Aciego P., Arnaiz-Villena A. Immunogenetics of systemic lupus erythematosus in Spanish patients: differential HLA markers. Immunobiology. 1991 Aug;182(5):465–471. doi: 10.1016/s0171-2985(11)80210-x. [DOI] [PubMed] [Google Scholar]
  8. Hauptmann G. Frequency of complement deficiencies in man, disease associations and chromosome assignment of complement genes and linkage groups. A summary of the data from the literature. Complement Inflamm. 1989;6(2):74–80. doi: 10.1159/000463077. [DOI] [PubMed] [Google Scholar]
  9. Hauptmann G., Tappeiner G., Schifferli J. A. Inherited deficiency of the fourth component of human complement. Immunodefic Rev. 1988;1(1):3–22. [PubMed] [Google Scholar]
  10. Inai S., Akagaki Y., Moriyama T., Fukumori Y., Yoshimura K., Ohnoki S., Yamaguchi H. Inherited deficiencies of the late-acting complement components other than C9 found among healthy blood donors. Int Arch Allergy Appl Immunol. 1989;90(3):274–279. doi: 10.1159/000235037. [DOI] [PubMed] [Google Scholar]
  11. Kinoshita T., Dodds A. W., Law S. K., Inoue K. The low C5 convertase activity of the C4A6 allotype of human complement component C4. Biochem J. 1989 Aug 1;261(3):743–748. doi: 10.1042/bj2610743. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lachmann P. J. Heberden oration 1986. Complement--friend or foe? Br J Rheumatol. 1987 Dec;26(6):409–415. doi: 10.1093/rheumatology/26.6.409. [DOI] [PubMed] [Google Scholar]
  13. Lopez-Trascasa M., Prevot D., Moisy M., Blanc C., Lagrue G., Sobel A. T. Quantitation of C2 by rocket immunoelectrophoresis in 120 pathological sera. Pathol Biol (Paris) 1981 Oct;29(8):481–485. [PubMed] [Google Scholar]
  14. Nelson R. A., Jr, Jensen J., Gigli I., Tamura N. Methods for the separation, purification and measurement of nine components of hemolytic complement in guinea-pig serum. Immunochemistry. 1966 Mar;3(2):111–135. doi: 10.1016/0019-2791(66)90292-8. [DOI] [PubMed] [Google Scholar]
  15. Nemerow G. R., Gewurz H., Osofsky S. G., Lint T. F. Inherited deficiency of the seventh component of complement associated with nephritis. Propensity to formation of C56 and related C7-consuming activity. J Clin Invest. 1978 Jun;61(6):1602–1610. doi: 10.1172/JCI109080. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Regueiro J. R., Arnaiz-Villena A. Human MHC class III (Bf, C2, C4) genes and GLO: their association with other HLA antigens and extended haplotypes in the Spanish population. Tissue Antigens. 1988 Jan;31(1):14–25. doi: 10.1111/j.1399-0039.1988.tb02060.x. [DOI] [PubMed] [Google Scholar]
  17. Ross S. C., Densen P. Complement deficiency states and infection: epidemiology, pathogenesis and consequences of neisserial and other infections in an immune deficiency. Medicine (Baltimore) 1984 Sep;63(5):243–273. [PubMed] [Google Scholar]
  18. Rowe P. C., McLean R. H., Wood R. A., Leggiadro R. J., Winkelstein J. A. Association of homozygous C4B deficiency with bacterial meningitis. J Infect Dis. 1989 Sep;160(3):448–451. doi: 10.1093/infdis/160.3.448. [DOI] [PubMed] [Google Scholar]
  19. Schifferli J. A., Ng Y. C., Peters D. K. The role of complement and its receptor in the elimination of immune complexes. N Engl J Med. 1986 Aug 21;315(8):488–495. doi: 10.1056/NEJM198608213150805. [DOI] [PubMed] [Google Scholar]
  20. Schneider P. M., Carroll M. C., Alper C. A., Rittner C., Whitehead A. S., Yunis E. J., Colten H. R. Polymorphism of the human complement C4 and steroid 21-hydroxylase genes. Restriction fragment length polymorphisms revealing structural deletions, homoduplications, and size variants. J Clin Invest. 1986 Sep;78(3):650–657. doi: 10.1172/JCI112623. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Segurado O. G., Arnaiz-Villena A. Two BF F subtypes, but no BF S, BF F1 or BF S07 subdivision, are found by isoelectric focusing. Vox Sang. 1989;56(2):117–121. doi: 10.1111/j.1423-0410.1989.tb04963.x. [DOI] [PubMed] [Google Scholar]
  22. Segurado O. G., Iglesias-Casarrubios P., Vicario J. L., Corell A., Regueiro J. R., Arnaiz-Villena A. Shared SstI RFLPs by HLA-Aw19, A23/24 and A3/11 crossreacting groups. Tissue Antigens. 1990 May;35(5):206–210. doi: 10.1111/j.1399-0039.1990.tb01784.x. [DOI] [PubMed] [Google Scholar]
  23. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  24. Welch T. R., Beischel L. S., Choi E. M. Molecular genetics of C4B deficiency in IgA nephropathy. Hum Immunol. 1989 Dec;26(4):353–363. doi: 10.1016/0198-8859(89)90012-8. [DOI] [PubMed] [Google Scholar]
  25. Yu C. Y., Campbell R. D. Definitive RFLPs to distinguish between the human complement C4A/C4B isotypes and the major Rodgers/Chido determinants: application to the study of C4 null alleles. Immunogenetics. 1987;25(6):383–390. doi: 10.1007/BF00396104. [DOI] [PubMed] [Google Scholar]
  26. Zeitz H. J., Miller G. W., Lint T. F., Ali M. A., Gewurz H. Deficiency of C7 with systemic lupus erythematosus: solubilization of immune complexes in complement-deficient sera. Arthritis Rheum. 1981 Jan;24(1):87–93. doi: 10.1002/art.1780240114. [DOI] [PubMed] [Google Scholar]

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