Complement and endothelium are key to understanding the development of thrombotic micronagiopathies
The Barcelona Endothelium Team, led by Enric Carreras, publishes a case review linked to previous work to detect whether the cause of thrombotic microangiopathy in Multiple Myeloma patients treated with carfilzomib is due to activation of the complement pathway, a cause that can be inhibited with a drug already on the market.
A few months ago, researchers led by Dr. Marta Palomo, from the Barcelona Endothelium Team of the Josep Carreras Institute, and Miquel Blasco, from Hospital Clínic of Barcelona, published a technique to detect whether the cause of thrombotic microangiopathy (TMA) was the activation of the complement pathway by C5b9 protein complex. TMA are lesions of the endothelium, the tissue that lines the inside of blood vessels, which cause platelet thrombi and depending on where they occur, leading to organ and even systemic failure. TMA is a phenomenon associated with several diseases, including COVID19.
The complement pathway is the cause of TMA atypical Haemolytic Uremic Syndrome (aHUS), which treatment consists of a drug that blocks it. The technique for detecting this pathway aims to reveal whether it is also the cause of TMA other than aHUS, such as pre-eclampsia and HELLP syndrome in pregnant women, lupus, and other diseases. Being able to detect the pathway in each patient could be useful to apply the same treatment in other diseases, gain time, and chances of saving the patient's life.
A few days ago, Marta Palomo and Miquel Blasco published a case study in the prestigious British Journal of Haematology, which analyzed the role of the complement pathway in 4 patients with multiple myeloma treated with carfilzomib, that developed TMA. In this work, the researchers detected an overactivation of the complement in three of the four patients. Using this technique, which analyzes the deposition of C5b9 on endothelial cell culture, the researchers can learn whether complement plays a role in the development of TMA and whether the patient might benefit from complement inhibitor treatments.
The work of the Barcelona Endothelium Team has been cited recently in a report by the SINC agency, which addresses the symptoms of SARS-CoV-2 according to the cells that coronavirus infects, as in which organs and tissues happen. This process is not unique to this coronavirus, and beyond the airways and lungs, COVID19 can also generate damage to other organs due to inflammation of the endothelium in them.