{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T14:22:27Z","timestamp":1793110947482,"version":"4.5.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Complement alternative pathway (AP) activation is linked to immunoglobulin A nephropathy (IgAN) prognosis severity, but Bb fragment's role is unclear. We examined the relationship between serum Bb fragment concentration at IgAN diagnosis and disease activity and outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective study included 125 biopsy-proven IgAN patients [age 39.9\u00a0years, 75% male, estimated glomerular filtration rate (eGFR) 82\u00a0ml\/min, proteinuria 0.5\u00a0g\/day] enrolled from 1984 to 2010 and followed for a minimum of 18\u00a0months. Monitoring continued until the last follow-up, end-stage kidney disease (ESKD) or death. Serum Bb fragment was measured using an enzyme-linked immunosorbent assay at diagnosis. Oxford classification and global optical score (GOS) were utilized for pathology assessment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients were followed for a median of 16\u00a0years; 42% developed chronic kidney disease stage \u22653, 19% reached ESKD and 9% died. Serum Bb fragment concentration negatively correlated with eGFR values at the last follow-up and positively with vascular and tubular histopathological indices. In univariate Cox regression analyses, higher Bb fragment concentration was associated with ESKD alongside older age, increased body mass index, arterial hypertension, lower eGFR, higher proteinuria, E1, S1, T1\u20132, GOS and corticotherapy. Patients with Bb levels \u226514.3\u00a0\u03bcg\/ml had shorter mean kidney survival time (19.5 versus 22.7\u00a0years, P\u00a0=\u00a0.07); after adjusting for progression risk factors, the association persisted [hazard ratio 4.76 (95% confidence interval 1.56\u201314.43)].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Serum Bb fragment concentration at diagnosis may predict long-term IgAN outcomes, potentially due to AP activation at the endothelial surface. Further research is needed to confirm these results and evaluate Bb fragment's role in IgAN management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfad163","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T02:32:10Z","timestamp":1696991530000},"page":"ii11-ii18","source":"Crossref","is-referenced-by-count":10,"title":["Circulating alternative pathway complement cleavage factor Bb is associated with vascular lesions and outcomes in IgA nephropathy"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7336-5874","authenticated-orcid":false,"given":"Gabriel","family":"\u0218tefan","sequence":"first","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00f4pital Nord CHU Saint Etienne , Saint Etienne , France"},{"name":"University of Medicine and Pharmacy \u201cCarol Davila\u201d, Nephrology Department , Bucharest , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perrine","family":"Jullien","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00f4pital Nord CHU Saint Etienne , Saint Etienne , France"},{"name":"Groupe Immunit\u00e9 muqueuse et agents pathog\u00e8nes (GIMAP, team 15 CIRI INSERM U1111\/UMR5108) , Saint Etienne , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Masson","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00f4pital Nord CHU Saint Etienne , Saint Etienne , France"},{"name":"Groupe Immunit\u00e9 muqueuse et agents pathog\u00e8nes (GIMAP, team 15 CIRI INSERM U1111\/UMR5108) , Saint Etienne , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Alamartine","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00f4pital Nord CHU Saint Etienne , Saint Etienne , France"},{"name":"Groupe Immunit\u00e9 muqueuse et agents pathog\u00e8nes (GIMAP, team 15 CIRI INSERM U1111\/UMR5108) , Saint Etienne , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Mariat","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00f4pital Nord CHU Saint Etienne , Saint Etienne , France"},{"name":"Groupe Immunit\u00e9 muqueuse et agents pathog\u00e8nes (GIMAP, team 15 CIRI INSERM U1111\/UMR5108) , Saint Etienne , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3073-7252","authenticated-orcid":false,"given":"Nicolas","family":"Maillard","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00f4pital Nord CHU Saint Etienne , Saint Etienne , France"},{"name":"Groupe Immunit\u00e9 muqueuse et agents pathog\u00e8nes (GIMAP, team 15 CIRI INSERM U1111\/UMR5108) , Saint Etienne , 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