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A survey of ficolin-3 activity in Systemic lupus erythematosus reveals a link to hematological disease manifestations and autoantibody profile
Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.ORCID iD: 0000-0001-8259-3863
Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden.
Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden.
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2024 (English)In: Journal of Autoimmunity, ISSN 0896-8411, E-ISSN 1095-9157, Vol. 143, article id 103166Article in journal (Refereed) Published
Abstract [en]

The complement system plays a central role in the pathogenesis of Systemic Lupus Erythematosus (SLE), but most studies have focused on the classical pathway. Ficolin-3 is the main initiator of the lectin pathway of complement in humans, but its role in systemic autoimmune disease has not been conclusively determined. Here, we combined biochemical and genetic approaches to assess the contribution of ficolin-3 to SLE risk and disease manifestations. Ficolin-3 activity was measured by a functional assay in serum or plasma samples from Swedish SLE patients (n = 786) and controls matched for age and sex (n = 566). Genetic variants in an extended 300 kb genomic region spanning the FCN3 locus were analyzed for their association with ficolin-3 activity and SLE manifestations in a Swedish multicenter cohort (n = 985). Patients with ficolin-3 activity in the highest tertile showed a strong enrichment in an SLE cluster defined by anti-Sm/DNA/nucleosome antibodies (OR 3.0, p < 0.001) and had increased rates of hematological disease (OR 1.4, p = 0.078) and lymphopenia (OR = 1.6, p = 0.039). Genetic variants associated with low ficolin-3 activity mapped to an extended haplotype in high linkage disequilibrium upstream of the FCN3 gene. Patients carrying the lead genetic variant associated with low ficolin-3 activity had a lower frequency of hematological disease (OR 0.67, p = 0.018) and lymphopenia (OR 0.63, p = 0.031) and fewer autoantibodies (p = 0.0019). Loss-of-function variants in the FCN3 gene were not associated with SLE, but four (0.5 %) SLE patients developed acquired ficolin-3 deficiency where ficolin-3 activity in serum was depleted following diagnosis of SLE. Taken together, our results provide genetic and biochemical evidence that implicate the lectin pathway in hematological SLE manifestations. We also identify lectin pathway activation through ficolin-3 as a factor that contributes to the autoantibody response in SLE.

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 143, article id 103166
Keywords [en]
Autoantibodies, Complement system, Ficolin-3, Lectin pathway, Systemic lupus erythematosus
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:umu:diva-220019DOI: 10.1016/j.jaut.2023.103166ISI: 001166254200001PubMedID: 38219652Scopus ID: 2-s2.0-85182582637OAI: oai:DiVA.org:umu-220019DiVA, id: diva2:1832384
Funder
Göran Gustafsson Foundation for Research in Natural Sciences and MedicineAgnes and Mac Rudberg FoundationSwedish Rheumatism AssociationStiftelsen Konung Gustaf V:s 80-årsfondSwedish Society of MedicineSwedish Research Council, 2018-02551Swedish Research Council, 2018-02399Swedish Research Council, 2021–02252Swedish Research Council, 2018-02535Swedish Research Council, 2022–00783Swedish Heart Lung FoundationSwedish National Infrastructure for Computing (SNIC)Swedish Research Council, 2018-05973Swedish Research Council, 2022–06725Harald Jeanssons stiftelseAvailable from: 2024-01-29 Created: 2024-01-29 Last updated: 2025-04-24Bibliographically approved

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Rantapää-Dahlqvist, Solbritt

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