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Inicio Medicina Clínica Implicaciones patogénicas, pronósticas y terapéuticas del complemento en las ...
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Vol. 161. Issue 4.
Pages 160-165 (August 2023)
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Vol. 161. Issue 4.
Pages 160-165 (August 2023)
Revisión
Implicaciones patogénicas, pronósticas y terapéuticas del complemento en las vasculitis asociadas a anticuerpo anticitoplasma de neutrófilo con afectación renal
Complement in vasculitis associated with anti-neutrophil cytoplasm antibodies with renal involvement: pathogenic, prognostic and therapeutic implications
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Manuel Heras Benito
Servicio de Nefrología, Hospital Universitario de Salamanca, Salamanca, España
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Resumen

Las vasculitis asociadas a anticuerpo anticitoplasma de neutrófilo son vasculitis primarias, que afectan a vasos pequeños de diversos órganos, entre ellos el riñón. La afectación renal, se caracteriza por presencia de glomerulonefritis con semilunas y necrosis en microscopia óptica y un patrón pauciinmune en la inmunofluorescencia. La participación del complemento en la patogenia de estas entidades se ha puesto en valor en los últimos años, inicialmente en modelos animales y posteriormente en estudios en humanos, al demostrarse la presencia de fragmentos de la vía alternativa complemento, en plasma y en orina, junto con depósitos de complemento en glomérulos y pequeños vasos de pacientes afectos por vasculitis anticuerpo anticitoplasma de neutrófilo. La presencia de complemento en estas entidades confiere peor pronóstico general y renal.

Palabras clave:
Complemento
Vasculitis
Anticuerpo anticitoplasma de neutrófilo
Fármacos anticomplemento
Abstract

Antineutrophil cytoplasmic antibody-associated vasculitides are primary vasculitides that affect small vessels in various organs, including the kidney. Renal involvement is characterized by the presence of glomerulonephritis with crescents and necrosis in light microscopy and a pauci-immune pattern in immunofluorescence. The participation of complement in the pathogenesis of these entities has been valued in recent years, initially in animal models and later in studies in humans, by demonstrating the presence of fragments of the alternative complement pathway, in plasma and urine, together with complement deposits in glomeruli and small vessels of patients affected by antineutrophil cytoplasmic antibody vasculitis. The presence of complement in these entities confers a worse general and renal prognosis.

Keywords:
Complement
Vasculitis
Anti-neutrophil cytoplasmic antibody
Anticomplement drugs

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