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The complement component C5 is not responsible for the alternative pathway activity in rabbit erythrocyte hemolytic assays during eculizumab treatment

Cellular & Molecular Immunology volume 17, pages 653–655 (2020)Cite this article

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Eculizumab is a therapeutic complement C5 inhibitor approved for the treatment of atypical hemolytic uremic syndrome (aHUS), paroxysmal nocturnal proteinuria (PNH), generalized myasthenia gravis and neuromyelitis optica spectrum disorder. Correct dosing of eculizumab is important to ensure complete complement blockade. Complement activity is often monitored by measuring either formation of the C5 activation product C5b-9 in vitro using an ELISA, independent of red blood cells, or by hemolytic assays measuring hemoglobin release from erythrocytes. Both approaches allow analysis of complement activation via the classical (CP) and alternative (AP) pathways.

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Acknowledgements

This project was supported by grants from ZonMw, “Goed Gebruik Geneesmiddelen” (project number 836031008), and the Zorgverzekeraars Nederland and Dutch Kidney Foundation (13OCA27 COMBAT Consortium).

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Authors and Affiliations

  1. Department of Pediatric Nephrology Amalia Children’s Hospital, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands

    Lambertus P. van den Heuvel, Nicole C. A. J. van de Kar, Andrei Sarlea, Thea J. A. M. van der Velden, Wilhelmus T. B. Liebrand, Romy Bouwmeester & Elena B. Volokhina

  2. Department of Laboratory Medicine, Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands

    Lambertus P. van den Heuvel, Sanne van Kraaij & Elena B. Volokhina

  3. Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium

    Lambertus P. van den Heuvel

  4. Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands

    Caroline Duineveld & Jack F. M. Wetzels

  5. Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway

    Camilla Schjalm & Tom E. Mollnes

  6. Research Laboratory, Nordland Hospital, Bodø, and K. G. Jebsen TREC, University of Tromsø, Tromsø, Norway

    Tom E. Mollnes

  7. Center of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway

    Tom E. Mollnes

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  1. Lambertus P. van den Heuvel
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  12. Elena B. Volokhina
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Corresponding author

Correspondence to Elena B. Volokhina.

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Competing interests

Prof. Dr. Jack F.M. Wetzels is a member of the international advisory board of Alexion and also received a grant from Alexion. Other authors have no conflict of interest.

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van den Heuvel, L.P., van de Kar, N.C.A.J., Duineveld, C. et al. The complement component C5 is not responsible for the alternative pathway activity in rabbit erythrocyte hemolytic assays during eculizumab treatment. Cell Mol Immunol 17, 653–655 (2020). https://doi.org/10.1038/s41423-020-0406-y

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