Complement component 3 glomerulopathy (C3G) defines a group of newly classified disorders that is due to C3 deposition in glomeruli. Very few outbreaks of this disease have been reported in the world. In this study, a 56 year old woman is reported who had complaints of weakness, abdominal pain, and skin petechiae and purpura. Laboratory tests revealed mild anemia and high serum creatinine level. Complementary studies were performed and the patient was suspected of having some form of vasculitis, especially PAN and Henoch Schonlein. Negative differential diagnosis of the most common reviews were obtained and due to lack of response to conventional therapy including corticosteroids and endoksan, kidney biopsy was done to detect the diagnosis. The patient was diagnosed with C3G. She had loss of consciousness, severe anemia, and rectorhalgia and transferred to Intensive Care Unit but died despite therapeutic efforts.

In this paper, we study the class of C 3-like Finsler metrics which contains the class of semi-C-reducible Finsler metric. We find a condition on C 3-like metrics under which the notions of Landsberg curvature and mean Landsberg curvature are equivalent.

History and Objectives: Hypertension is one of the common diseases with complications that lead to death. Some researches has argued that in patients with hypertension, the level of C3 in serum is elevated. This study was carried out to determine the level of C3 in patients with hypertension and to compare it with control group in Isfahan province in 1998.Materials and Methods: The analytical strategy of this study was randomly performed on 60 patients with hypertension and on 60 normal persons. The SRID method was used to determine the level of C3 in serum. Both groups were similar regarding age and gender. For statistical analysis t-test was used. Results: C3 level was 85 ± 13 in normal persons and 131 ± 32 mg/dl in patients with hypertension with a 54% difference (P<0.0001). in addition, its level showed no relationship with gender. In patients with hypertension, there was a lower increase in the level of C3 with age.Conclusion: Hypertension can increase the level of C3 in serum. It is recommended to carry out a cohort research study for finding a relationship between an increase in the level of C3 in patients with hypertension and incidence of atherosclerosis.

Extended AbstractBackground and Aim: There is evidence that components of the innate immune system, particularly the complement system, play a role in multiple sclerosis (MS) (1, 2). The complement system, a key element of innate immunity (1), consists of blood proteins involved in inflammation and host defense. C3 and C4 are potential diagnostic markers for autoimmune inflammatory demyelinating diseases of the central nervous system (CNS). Their activation is central to the complement system and contributes to neurodegeneration in MS (4, 7). Studies have shown that plasma levels of C3 and C4 are elevated in MS patients compared to healthy controls (2). In addition to pharmacological treatments, lifestyle modifications, such as physical activity, can effectively modulate the complement system without adverse effects. Therefore, the aim of this study was to investigate the effects of combined physical C3 and C4, the C3/C4 ratio and motor function in women with multiple sclerosis.Materials and Methods: The present study employed a pretest-posttest design involving 30 patients aged 30 to 40 years who were diagnosed with multiple sclerosis (MS) according to the McDonald 2010 criteria. Participants were randomly assigned to two groups: an experimental group (n=15) that participated in an exercise program and a control group (n=15) that went about their normal daily activities. The inclusion criteria required an Expanded Disability Status Scale (EDSS) score of less than five, as determined by a neurological examination by a physician (20). Participants had to be able to move independently and voluntarily consent to participate in the study. Exclusion criteria included inflammatory conditions such as metabolic syndrome, cardiovascular problems (including hypertension), kidney problems, asthma, potential neuropathic pain in the lower extremities, severe cognitive impairment, visual impairment, drug dependence (alcohol or smoking), comorbidities that could interfere with participation, recent MS relapses within the last eight weeks, pregnancy or regular exercise in the last six months (21). Blood samples and motor function assessments were taken 72 hours before and after the training protocol in a fasting state. C3 and C4 levels were measured using the turbidometry method. Motor function was assessed with the timed up and test (TUG) and the balance test (FTSST). The exercises protocol followed the American College of Sports Medicine (ACSM) guidelines for patients with MS (26). The program lasted 12 weeks, with sessions taking place three days a week and lasting approximately one hour each. It included: a) aerobic exercise at 40-60% of maximum heart rate (MHR), b) resistance exercises with a yellow band consisting of three sets of eight to fifteen repetitions, c) balance exercises in standing and dynamic positions, and d) seated stretching exercises with controlled breathing, based on methods from previous studies. The data were analyzed using analysis of covariance with the significance level of p<0.05.Findings: At baseline, an independent t-test showed that the initial characteristics of weight (experimental group: 65.41±11.70 kg; control group: 58.58±12.68 kg; p=0.72) and MS history (experimental group: 51.75±3.30 years; control group: 21.83±6.30 years; p=0.66) were similar in both groups. After 12 weeks of combined training, the experimental group showed a significant reduction in serum levels of complement C3 compared to the control group (p=0.01). However, there were no significant differences between the groups in complement C4 levels or the C3/C4 ratio (p>0.05). In addition, the experimental group showed significant improvements in motor performance, (fall risk and balance), as well as a significant reduction in walking times compared to the control group (p<0.05) (Table 1).Conclusion: The current evidence on the effects of exercise on complement components C3 and C4 in individuals with MS remains limited and somewhat conflicting. One review found that the C3 and C4 family proteins are the best studied. Complement proteins were found to be transiently activated immediately after acute exercise and remain elevated for up to 72 hours after strength training and ultra-endurance running. Conversely, prolonged exercise and higher cardiorespiratory fitness levels are associated with a decrease in C3 family proteins (32). The response of complement proteins depends on the type of exercise. Endurance exercise tends to decrease C3 and increase C4, while anaerobic (fast) exercise reduces C4(12). The observed decrease in C3 following combined training may be due to a reduction in inflammatory mediators that activate the complement cascade. Combined training (strength and endurance training) has been shown to improve motor function and reduce inflammation in women with MS (36). In contrast to acute exercise, exercise reduces inflammatory proteins that activate the complement system, such as C-reactive protein (CRP), as well as cells such as monocytes that secrete these proteins (32). In this study, combined exercises were more effective in improving balance. Conversely, in studies that did not show significant improvements in balance, balance exercises alone were found to be insufficient (30). As for the effects of breathing exercises on the immune system, research in psychoneuroimmunology suggests that these exercises may alter immune markers and promote health by modulating the adrenocorticotropin-cortisol immune pathway (40). Overall, the combination of resistance, aerobic, balance, and breathing exercises appears to enhance both immunological and functional outcomes in individuals with MS. These findings support the recommendation of such multifaceted exercise programs as a beneficial non-pharmacological intervention for this population.Ethical considerations: Before starting the protocol, a consent form was signed by the subjects and an ethics ID number IR.AZARUNIV.REC.1402.014 was obtained.Conflict of interest: There are no conflicts of interest.

Introduction: Fetal loss and recurrent abortion account for significant emotional distress for couples desiring children. Regarding the etiologic importance, this study has been carried out to determine the serum level of C3 and C4 in women with recurrent miscarriage.Material and Methods: This case control study was carried out in Shariatee Hospital of Bandar Abbas University of Medical Sciences, during 2000-2001. 109 women with definite diagnosis of recurrent abortion or fetal loss as patients and 220 matched women with at least two successful deliveries and negative history of miscarriage as controls were studied. The sera of the patients and the controls were tested by SRID method for determining C3 and C4.Results: The prevalence of reduced serum levels of C3 and C4 in the patients and the controls were 22.02% and 5% respectively and that of C4 in the patients and the controls were 24.77% and 8.18%, respectively. There was a significant difference between the prevalence of reduced serum level of C3 and C4 in the patients and controls (p<0.001).Conclusion: The results of this study suggest that the complement system plays a significant role in recurrent miscarriage. Further studies are needed to explore the role of immune system - classical pathway of complement system-in fetal loss and spontaneous abortion.

Complement C3 glomerulopathy refers to a disease process in which abnormal control of complement activation or degradation results in predominant C3 fragment deposition within the glomerulus and causes glomerular damage. Abnormal control of the complement alternative pathway is a well-established risk factor for the occurrence of C3 glomerulonephritis. It is the first reported case in Iran with multiple mutations in complement factor H, with one of these mutations we have expected in hemolytic uremic syndrome rather than C3 glomerulopathy. Genetic analysis showed that the molecular abnormalities of factor H led to complement factor H malfunction that were polymorphous and not restricted to the C-terminal domains of the protein.

Background and Objectives: Complement proteins are some of the most important plasma proteins of the innate immune system. Impaired immune function is reported in subjects who are iron deficient, and there are documents that these patients are prone to infection. This study was conducted to show whether serum C3 and C4 complement change in adult nonpregnant female with iron deficient anemia or not.Methods: Forty five normal subjects and 45 iron deficient anemia (hypochrom microcytic) cases were entered in this case and control study by using patients’ clinical history and also results of CBC, Serum ferritin, iron and total iron binding capacity. Serum C3, and C4 were measured in case and control subjects with nephlometry method, finally comparison between result of patients group and control group was done with using suitable statistical test.Results: Mean serum C3 and C4 in patient group was 1.28 ± 0.81 and 0.28 ± 0.23 g/L respectively and for control group was 1.39 ± 0.87 and 0.35 ± 0.25 g/L respectively. Although serum complements were slightly lower in patient groups in compared to control group but this differences was not meaningful with t test.Conclusion: This study showed serum C3 and C4 complements levels were not changed in iron deficiency anemia.

Two-thirds of complement C3 glomerulopathy (C3G) recur after transplantation and commonly cause graft loss. There is not a standard treatment protocol for these cases. We present a kidney transplant patient with recurrent C3G who was successfully treated with eculizumab. Nephrotic proteinuria and hematuria occurred and creatinine levels increased after transplantation. A graft biopsy revealed recurrent C3G. The patient was administered 250 mg pulse methylprednisolone for 3 days and had 9 sessions of plasmapheresis. Since elevated creatinine levels and proteinuria persisted, eculizumab was instituted. A complete remission was observed after 9-month maintenance eculizumab treatment. Eculizumab may be a potentially effective option in kidney transplant patients with recurrent C3G unresponsive to other treatment modalities.

The patterns of geographic distribution of C3 and C4 species of the family Chenopodiaceae have been analyzed in Iran, using a database of 11151 georeferenced records. The members of Chenopodiaceae family with 45 genera and 204 species are widely distributed in Iran. There they show a ratio of about 2:1 between C4 and C3 species. All available data were organized in MS access database, and analyzed in point-to-grid analysis tool of DIVA-GIS software, using 10´10 km grid cells and the circular neighborhood option. The highest species numbers, with a peak at 83 per grid unit, occur in Tehran, Semnan, and East Azerbaijan provinces but the density of records is extremely uneven. Consequently, the same areas also are the hot spots of both C4 and C3 species. The comparison between the distribution patterns of carbon isotope composition ( δ13C) values of species and the annual precipitation gradient map represents that C4 Chenopods are well adapted to regions with high degree of aridity and low precipitation.

In this paper, we study the class of C3-like Finsler metrics with relatively isotropic mean Landsberg. We find some conditions under which these metrics reduce to relatively isotropic Landsberg metrics