Complement-Mediated Glomerular Diseases: A Tale of 3 Pathways

Abstract

A renewed interest in the role of complement in the pathogenesis of glomerular diseases has improved our understanding of their basic, underlying physiology. All 3 complement pathways—classical, lectin, and alternative—have been implicated in glomerular lesions both rare (e.g., dense deposit disease) and common (e.g., IgA nephropathy). Here we review the basic function of these pathways and highlight, with a disease-specific focus, how activation can lead to glomerular injury. We end by exploring the promise of complement-targeted therapies as disease-specific interventions for glomerular diseases.

Keywords

• complement
• glomerulonephritis
• nephrotic syndrome
• membranous nephropathy
• lupus
• IgA nephropathy
• C3 glomerulopathy