{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:31:37Z","timestamp":1780511497471,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Immunol"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy that may lead to organ failure. Dysregulation of the complement system can cause aHUS, and various disease\u2010related variants in the complement regulatory protein CD46 are described. We here report a pediatric patient with aHUS carrying a hitherto unreported homozygous variant in <jats:italic>CD46<\/jats:italic> (NM_172359.3:c.602C&gt;T p.(Ser201Leu)). In our functional analyses, this variant caused complement dysregulation through three separate mechanisms. First, CD46 surface expression on the patient's blood cells was significantly reduced. Second, stably expressing CD46(Ser201Leu) cells bound markedly less to patterns of C3b than CD46 WT cells. Third, the patient predominantly expressed the rare isoforms of CD46 (C dominated) instead of the more common isoforms (BC dominated). Using BC1 and C1 expressing cell lines, we found that the C1 isoform bound markedly less C3b than the BC1 isoform. These results highlight the coexistence of multiple mechanisms that may act synergistically to disrupt CD46 function during aHUS development.<\/jats:p>","DOI":"10.1002\/eji.202249838","type":"journal-article","created":{"date-parts":[[2022,8,21]],"date-time":"2022-08-21T00:24:02Z","timestamp":1661041442000},"page":"1610-1619","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Novel homozygous CD46 variant with C\u2010isoform expression affects C3b inactivation in atypical hemolytic uremic syndrome"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1365-3938","authenticated-orcid":false,"given":"Vivien R.","family":"Schack","sequence":"first","affiliation":[{"name":"Department of Biomedicine Aarhus University  Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7179-4643","authenticated-orcid":false,"given":"Morten K.","family":"Herlin","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Aarhus University Hospital  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology and Genetics Aarhus University  Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Magnus Bernth","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology Aarhus University Hospital  Aarhus N Denmark"},{"name":"Department of Molecular Medicine Aarhus University Hospital  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"F\u00e6rch","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Aarhus University Hospital  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Bundgaard","sequence":"additional","affiliation":[{"name":"Department of Biomedicine Aarhus University  Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus K.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology and Genetics Aarhus University  Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uffe B.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Aarhus University Hospital  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics Aarhus University Hospital  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregers R.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology and Genetics Aarhus University  Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Thiel","sequence":"additional","affiliation":[{"name":"Department of Biomedicine Aarhus University  Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5314-5818","authenticated-orcid":false,"given":"Per","family":"H\u00f6llsberg","sequence":"additional","affiliation":[{"name":"Department of Biomedicine Aarhus University  Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30062-4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-6-60"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-015-3076-8"},{"key":"e_1_2_11_5_1","first-page":"400","article-title":"The genetics of atypical hemolytic uremic syndrome","volume":"30","author":"Feitz W. 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