Anti-factor B antibodies in atypical hemolytic uremic syndrome.

BACKGROUND: The etiology of atypical hemolytic uremic syndrome (aHUS) is unknown in 30-40% of patients. Anti-factor B (FB) antibodies are reported in C3 glomerulopathy (C3G) and immune-complex membranoproliferative glomerulonephritis (IC-MPGN), though not in aHUS. METHODS: We screened patients < 18-year-old from cohorts of aHUS and C3G/idiopathic IC-MPGN. Anti-FB IgG antibodies were measured by ELISA and confirmed by Western blot. Normative levels were based on antibody levels in 103 healthy blood donors. RESULTS: Prevalence of anti-FB antibodies was 9.7% (95% CI 6.1-14.5%; n = 21) in 216 patients with aHUS, including 11.5% (95% CI 6.4-18.5%; n = 14) in anti-FH associated aHUS and 11.8% (95% CI 4.4-23.9%; n = 6) in patients without a definitive genetic or autoimmune etiology. Patients with significant genetic variants did not show anti-FB antibodies. In patients with concomitant anti-FB and anti-FH antibodies, median anti-FH titers were higher (11,312 AU/mL vs. 4920 AU/mL; P = 0.04). Anti-FB antibody titer correlated with disease severity (hemoglobin and platelets; P < 0.05), declined following plasma exchange and increased during relapse. While 4/64 patients with C3G (6.3%) and 1/17 with IC-MPGN showed anti-FB antibodies, titers were higher in aHUS (544.8 AU/mL vs. 1028.8 AU/mL; P = 0.003). CONCLUSION: Anti-FB antibodies are present in 6-10% of patients with aHUS and C3G/IC-MPGN, with higher titers in the former. The diagnostic and therapeutic implication of anti-FB antibodies in aHUS needs confirmation and further studies. The study shows propensity for autoantibody generation and co-existence of multiple risk factors for aHUS in Indian children.

Agmatine reverses ethanol consumption in rats: Evidences for an interaction with imidazoline receptors.

Alcohol is one of the most widely abused recreational drugs, largely linked with serious health and social concerns. However, the treatment options for alcohol-use disorders have limited efficacy and exhibit a range of adverse drug reactions. Large numbers of preclinical studies have projected a biogenic amine, agmatine as a promising potential treatment option for drug addiction, including alcoholism. In the present study, administration of agmatine (20-40 mg/kg, i.p.) resulted in significant inhibition of ethanol self-administration in the right p-VTA in operant conditioning paradigm. Further, acute intracranial administration of agmatine (20 and 40 µg/rat) significantly reduced the ethanol consumption in the two bottle choice paradigm. Agmatine is degraded to putrescine and guanido-butanoic acid by the enzyme agmatinase and diamine oxidase respectively and inhibition of these enzymes results in augmentation of endogenous agmatine. In the present study, diamine oxidase inhibitor, aminoguanidine and agmatinase inhibitor, arcaine were used to block the agmatine metabolic pathways to increase brain agmatine levels. Drugs that augment endogenous agmatine levels like L-arginine (80 µg/rat, i.c.v.) or arcaine (50 µg/rat, i.c.v.) and aminoguanidine (25 µg/rat, i.c.v.) also reduced the ethanol consumption following their central administration. The pharmacological effect of agmatine on ethanol consumption was potentiated by imidazoline receptor agonists, I1 agonist moxonidine (25 µg/rat, i.c.v.), and imidazoline I2 agonist, 2-BFI (10 µg/rat, i.c.v.) and was blocked by imidazoline I1 antagonist, efaroxan (10 µg/rat, i.c.v.), and I2 antagonist, idazoxan (4 µg/rat, i.c.v.) at their ineffective doses per se. Thus, our result suggests the involvement of imidazoline I1 and I2 receptors in agmatine induced inhibition of ethanol consumption in rats.