Complement activation: The missing link between ADAMTS-13 deficiency and microvascular thrombosis of thrombotic microangiopathies

Maria Piedad Ruiz-Torres, Federica Casiraghi, Miriam Galbusera, Daniela Macconi, Sara Gastoldi, Marta Todeschini, Francesca Porrati, Daniela Belotti, Enrico Maria Pogliani, Marina Noris, Giuseppe Remuzzi

Research output: Contribution to journalArticle

Abstract

Endothelial injury is the central factor in the events leading to thrombotic microangiopathy (TMA); however, the mechanisms involved are not fully understood. Here we investigate the role of neutrophils (PMNs) and of complement activation in inducing microvascular damage and loss of thromboresistance in TMA associated with ADAMTS-13 deficiency. PMNs isolated during the acute phase of the disease released excessive amounts of reactive-oxygen species (ROS), N-derived oxidants and proteinases and induced damage and thromboresistance loss in human microvascular endothelial cell line (HMEC-1) ex vivo. Endothelial cytotoxicity and thromboresistance loss was also induced by TMA serum. Complement-derived products were responsible for the above effects: in fact, TMA serum caused C3 and Membrane Attack Complex (MAC) deposition on HMEC-1 and its cytotoxic effect was abolished by complement inhibition. TMA serum caused surface expression of P-selectin on HMEC-1 which may promote PMN adhesion and resulted in increased PMN cytotoxicity, indicating that complement may have a role in PMN activation. In addition, TMA serum stimulated control PMNs to release ROS and proteinases, and to cause endothelial cell cytotoxicity. All of the above effects were abrogated by complement inactivation. These data document for the first time that complement-initiated PMN activation and endothelial injury may have a crucial role in microvascular thrombosis of TMA associated with ADAMTS-13 deficiency.

Original languageEnglish
Pages (from-to)443-452
Number of pages10
JournalThrombosis and Haemostasis
Volume93
Issue number3
DOIs
Publication statusPublished - Mar 2005

Fingerprint

Thrombotic Microangiopathies
Complement Activation
Thrombosis
Serum
Reactive Oxygen Species
Peptide Hydrolases
Endothelial Cells
Complement Membrane Attack Complex
P-Selectin
Wounds and Injuries
Acute Disease
Oxidants
Neutrophils
Cell Line

Keywords

  • ADAMTS-13
  • Complement
  • Neutrophils
  • Reactive oxygen species
  • Thrombotic microangiopathy

ASJC Scopus subject areas

  • Hematology

Cite this

Complement activation : The missing link between ADAMTS-13 deficiency and microvascular thrombosis of thrombotic microangiopathies. / Ruiz-Torres, Maria Piedad; Casiraghi, Federica; Galbusera, Miriam; Macconi, Daniela; Gastoldi, Sara; Todeschini, Marta; Porrati, Francesca; Belotti, Daniela; Pogliani, Enrico Maria; Noris, Marina; Remuzzi, Giuseppe.

In: Thrombosis and Haemostasis, Vol. 93, No. 3, 03.2005, p. 443-452.

Research output: Contribution to journalArticle

Ruiz-Torres, Maria Piedad ; Casiraghi, Federica ; Galbusera, Miriam ; Macconi, Daniela ; Gastoldi, Sara ; Todeschini, Marta ; Porrati, Francesca ; Belotti, Daniela ; Pogliani, Enrico Maria ; Noris, Marina ; Remuzzi, Giuseppe. / Complement activation : The missing link between ADAMTS-13 deficiency and microvascular thrombosis of thrombotic microangiopathies. In: Thrombosis and Haemostasis. 2005 ; Vol. 93, No. 3. pp. 443-452.
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