Imperial College London


Faculty of MedicineDepartment of Immunology and Inflammation

Professor of Rheumatology



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BibTex format

author = {Wilson, HR and Medjeral-Thomas, NR and Gilmore, AC and Trivedi, P and Seyb, K and Farzaneh-Far, R and Gunnarsson, I and Zickert, A and Cairns, TD and Lightstone, L and Cook, HT and Pickering, MC},
doi = {10.1016/j.kint.2018.09.027},
journal = {Kidney International},
pages = {655--665},
title = {Glomerular membrane attack complex is not a reliable marker of ongoing C5 activation in lupus nephritis},
url = {},
volume = {95},
year = {2019}

RIS format (EndNote, RefMan)

AB - Complement plays an important role in the pathogenesis of lupus nephritis (LN). With the emergence of therapeutic complement inhibition, there is a need to identify patients in whom complement-driven inflammation is a major cause of kidney injury in LN. Clinical and histopathological data were obtained retrospectively from 57 biopsies with class III, IV, and V LN. Biopsies were stained for complement components C9, C5b-9, C3c, and C3d and for the macrophage marker CD68. C9 and C5b-9 staining were highly correlated (r = 0.92 in the capillary wall). C5b-9 staining was detected in the mesangium and/or capillary wall of both active and chronic proliferative LN in all but one biopsy and in the capillary wall of class V LN in all biopsies. C5b-9 staining intensity in the tubular basement membrane correlated with markers of tubulointerstitial damage, and more intense capillary wall C5b-9 staining was significantly associated with nonresponse to conventional treatment. Glomerular C5b-9 staining intensity did not differ between active and chronic disease; in contrast, C3c and CD68 staining were associated with active disease. Evaluation of serial biopsies and comparison of staining in active and chronic LN demonstrated that C5b-9 staining persisted for months to years. These results suggest that C5b-9 staining is almost always present in LN, resolves slowly, and is not a reliable marker of ongoing glomerular C5 activation. This limits the utility of C5b-9 staining to identify patients who are most likely to benefit from C5 inhibition.
AU - Wilson,HR
AU - Medjeral-Thomas,NR
AU - Gilmore,AC
AU - Trivedi,P
AU - Seyb,K
AU - Farzaneh-Far,R
AU - Gunnarsson,I
AU - Zickert,A
AU - Cairns,TD
AU - Lightstone,L
AU - Cook,HT
AU - Pickering,MC
DO - 10.1016/j.kint.2018.09.027
EP - 665
PY - 2019///
SN - 0085-2538
SP - 655
TI - Glomerular membrane attack complex is not a reliable marker of ongoing C5 activation in lupus nephritis
T2 - Kidney International
UR -
UR -
UR -
VL - 95
ER -