The disease-protective complement factor H allotypic variant Ile62 shows increased binding affinity for C3b and enhanced cofactor activity

Abstract

Mutations and polymorphisms in the gene encoding factor H (CFH) have been associated with atypical haemolytic uraemic syndrome, dense deposit disease and age-related macular degeneration. The disease-predisposing CFH variants show a differential association with pathology that has been very useful to unravel critical events in the pathogenesis of one or other disease. In contrast, the factor H (fH)-Ile(62) polymorphism confers strong protection to all three diseases. Using ELISA-based methods and surface plasmon resonance analyses, we show here that the protective fH-Ile(62) variant binds more efficiently to C3b than fH-Val(62) and competes better with factor B in proconvertase formation. Functional analyses demonstrate an increased cofactor activity for fH-Ile(62) in the factor I-mediated cleavage of fluid phase and surface-bound C3b; however, the two fH variants show no differences in decay accelerating activity. From these data, we conclude that the protective effect of the fH-Ile(62) variant is due to its better capacity to bind C3b, inhibit proconvertase formation and catalyze inactivation of fluid-phase and surface-bound C3b. This demonstration of the functional consequences of the fH-Ile(62) polymorphism provides relevant insights into the complement regulatory activities of fH that will be useful in disease prediction and future development of effective therapeutics for disorders caused by complement dysregulation.

Full text

The disease-protective complement factor H allotypic variant
Ile62 shows increased binding affinity for C3b and enhanced
cofactor activity
Agustín Tortajada1, Tamara Montes1, Ruben Martinez-Barricarte1, B. Paul Morgan2, Claire
L. Harris2,*, and Santiago Rodríguez de Córdoba1,*
1)Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas, Centro
de Investigación Biomédica en Enfermedades Raras and Instituto Reina Sofía de Investigaciones
Nefrológicas, Ramiro de Maeztu 9, 28040 Madrid, Spain.
2)Department of Medical Biochemistry and Immunology, School of Medicine, Cardiff University,
Cardiff, CF14 4XN, UK.
Summary
Mutations and polymorphisms in the gene encoding factor H (
CFH
) have been associated with
atypical haemolytic uraemic syndrome, dense deposit disease and age-related macular
degeneration. The disease-predisposing
CFH
variants show a differential association with
pathology that has been very useful to unravel critical events in the pathogenesis of one or other
disease. In contrast, the fH-Ile62 polymorphism confers strong protection to all three diseases.
Using ELISA-based methods and surface plasmon resonance analyses we show here that the
protective fH-Ile62 variant binds more efficiently to C3b than fH-Val62 and competes better with
factor B in proconvertase formation. Functional analyses demonstrate an increased cofactor
activity for fH-Ile62 in the factor I-mediated cleavage of fluid phase and surface-bound C3b;
however, the two fH variants show no differences in decay accelerating activity. From these data
we conclude that the protective effect of the fH-Ile62 variant is due to its better capacity to bind
C3b, inhibit proconvertase formation and catalyse inactivation of fluid-phase and surface-bound
C3b. This demonstration of the functional consequences of the fH-Ile62 polymorphism provides
relevant insights into the complement regulatory activities of fH that will be useful in disease
prediction and future development of effective therapeutics for disorders caused by complement
dysregulation.
Introduction
Complement is a major component of innate immunity with crucial roles in microbial
killing, apoptotic cell clearance and immune complex handling. Activation of complement
Corresponding authors: Dr. Santiago Rodríguez de Córdoba, Complement Genetics and Molecular Pathology Unit, Depart. of Cellular
and Molecular Physiopathology, Centro de Investigaciones Biologicas, Ramiro de Maeztu 9, Madrid 28040, Spain. Tel: (+34) 91
7373112 x4432 Fax: (+34) 91 5360432 srdecordoba@cib.csic.es Dr. Claire L Harris, Complement Biology Group, Depart. of Medical
Biochemistry and Immunology, School of Medicine, Cardiff University, Henry Wellcome Building, Heath Park, Cardiff, CF14 4XN,
UK. Tel: (+44) 29 20687012 Fax: (+44) 29 20687079 HarrisCL@cardiff.ac.uk.
*)These two authors contributed equally to this work.
Author’s contributions CLH, BPM and SRdeC designed research, analysed the data and wrote the paper. CLH and SRdeC contribute
equally to this work. AT, TM and RMB prepared the proteins. AT and CLH performed the binding and functional assays.
Publisher's Disclaimer: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Human Molecular
genetics following peer review. The definitive publisher-authenticated version [Hum. Mol. Genet. (2009) 18 (18): 3452-3461. doi:
10.1093/hmg/ddp289 First published online: June 23, 2009] is available at http://hmg.oxfordjournals.org/content/18/18/3452.long
Conflicts of interest Authors declare no conflict of interest
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by foreign surfaces (alternative pathway; AP), antibody (classical pathway; CP) or mannan
(lectin pathway; LP), causes target opsonisation, leukocyte recruitment, and cell lysis. The
critical steps in complement activation are the formation of unstable protease complexes,
named C3-convertases (AP, C3bBb; CP/LP, C4b2a) and the cleavage of C3 to generate C3b.
Convertase-generated C3b can form more AP C3-convertase, providing exponential
amplification to the initial activation. Binding of C3b to the C3-convertases generates the
C5-convertases with the capacity to bind and cleave C5, initiating formation of the lytic
membrane attack complex (MAC).
Nascent C3b binds indiscriminately to pathogens and adjacent host cells. To prevent damage
to self and to avoid wasteful consumption of components, complement is under the control
of multiple regulatory proteins that limit complement activation by inactivating C3b or C4b,
dissociating the multimolecular C3/C5 convertases or inhibiting MAC formation. In health,
activation of C3 in the blood is kept at a low level and deposition of C3b and further
activation of complement is limited to the surface of pathogens (1).
Factor H (fH) is a relatively abundant plasma protein that is essential to maintain
complement homeostasis and to restrict the action of complement to activating surfaces. fH
binds to C3b, accelerates the decay of the alternative pathway C3-convertase (C3bBb) and
acts as a cofactor for the fI-mediated proteolytic inactivation of C3b (2-4). fH regulates
complement both in fluid phase and on cellular surfaces (5-7). The factor H molecule is a
single polypeptide chain glycoprotein of 155 kDa composed of 20 repetitive units of ~60
amino acids (8), named short consensus repeats (SCR), arranged end-to-end like ‘beads on a
string’. fH presents different interaction sites for C3b and polyanions which delineate
distinct functional domains at the N- and C-termini. The C3b binding site in SCR1-4 is the
only site essential for the C3-convertase decay accelerating and fI cofactor activities of fH.
Similarly, the C3b/polyanion-binding site located within SCR19-20 is the most important
site for preventing alternative pathway activation through binding to host cell membranes
(9).
Several reports in the last few years have established that membranoproliferative
glomerulonephritis type II or dense deposit disease (MPGN2/DDD) (10-13), atypical
haemolytic uraemic syndrome (aHUS) (14-17) and age-related macular degeneration
(AMD) (18-21), are each associated with mutations or polymorphisms in the
CFH
gene. The
available data support the hypothesis that AP dysregulation is a unifying pathogenetic
feature of these diverse conditions. They also illustrate a remarkable genotype-phenotype
correlation in which distinct genetic variations at
CFH
specifically predispose to aHUS,
AMD or MPGN2. In addition to these
CFH
variants conferring increased risk to disease, one
common extended haplotype in the
CFH
gene has been described associated with lower risk
to aHUS, AMD and MPGN2/DDD (18, 22). This
CFH
haplotype carries the Ile62 variant
within the SCR1 domain in the N-terminal region that is essential for fH regulatory
activities. It is, therefore, possible that the substitution of Val for Ile at position 62 may
increase the fH regulatory activity and thus confer lower risk to AMD, MPGN2/DDD and
aHUS by reducing AP activation.
To test this hypothesis we have purified the two fH variants from the plasma of fH-Val62
and fH-Ile62 homozygote donors and performed a series of binding and functional analyses.
Our data show that the fH-Ile62 variant exhibits increased binding to C3b compared to fH-
Val62, and is also a more efficient cofactor for fI in the proteolytic inactivation of C3b.
Together these data provide an explanation for why fH-Ile62 protects from diseases
associated with AP dysregulation.
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Results
Interaction of fH-Ile62 and fH-Val62 with surface-bound C3b
Purified C3b was immobilized on microtiter plates and serial dilutions of fH-Ile62 or fH-
Val62 variants, ‘polished’ free from potential aggregates by gel filtration, were allowed to
interact with C3b for two hours at 37°C. Factor H bound to C3b was detected using an
antifH mAb (35H9) that recognises equally both variants as described in Materials and
Methods. Binding of the protective fH-Ile62 variant to surface-bound C3b was significantly
higher than that of the fH-Val62 variant (P<0.0001) (Figure 1a). These data suggest that the
Val62Ile polymorphism influences the interaction between fH and C3b. To confirm these
findings in a different assay, we performed SPR studies using chips coated with identical
amounts of fH-Ile62 or fH-Val62 variants and flowed increasing concentrations of C3b.
These SPR assays replicated and extended the findings from ELISA experiments, showing
that fH-Ile62 binds C3b with a higher affinity than fH-Val62 (Figure 2a). Steady state
analysis under defined buffer conditions gave a KD of 1.04μM for fH-Ile62 and 1.33μM for
fH-Val62 (Figure 2b).
Cofactor activity for fI-mediated proteolysis of fluid phase C3b
In order to study the fI cofactor activity of the fH-Ile62 and fH-Val62 variants we first
performed a fluid phase cofactor activity assay. Identical amounts of purified fH-Ile62 and
fH-Val62 variants were added to purified C3b in the presence of fI and incubated for 2.5, 5,
7.5 and 10 minutes at 37°C. Under the conditions of these experiments 100% of C3b
cleavage was reached after 20 minutes of incubation. Controls for 0% cleavage were
obtained in the absence of fI. The ratio between α′chain / βchain of C3b, determined by
densitometry, was used to determine the percentage of C3b cleavage. Figure 3a illustrates
one experiment representative of several, showing that the fH-Ile62 variant is more efficient
as a cofactor for fI in the cleavage of C3b in the fluid phase. Figure 3b shows a significant
difference (P=0.0012) in the % C3b cleavage catalysed by identical amounts of purified fH-
Ile62 and fH-Val62 variants at different incubation times. Double regression plotting and
statistical analysis of the slopes for the linearized curves reveal significant differences
between the cofactor activities of the fH-Ile62 and fH-Val62 variants. Figure 3c shows the
densitometry analysis for the differences in cofactor activities between the fH-Ile62 and fH-
Val62 variants at 6 minutes incubation time in an independent set of assays. From these
experiments it was calculated that fH-Ile62 is approximately 20% more active than fH-Val62
as a cofactor for the fI-mediated cleavage of fluid phase C3b.
Cofactor activity of fI-mediated inactivation of surface-bound C3b
To determine whether the fH-Ile62 variant is also more active than fH-Val62 as cofactor for
the fI-mediated inactivation of surface-bound C3b we used a haemolytic assay. C3b
deposited onto sheep erythrocytes was subjected to degradation by fI in the presence of
increasing amounts of purified fH-Ile62 or fH-Val62. For each fH concentration, the residual
surface-bound C3b was determined by measuring sheep erythrocyte lysis after lytic pathway
reconstitution (see Materials and Methods).
Three different experiments, each in triplicate, were performed with identical results (Figure
4). Calculated EC50 were 22.6nM and 14nM for fH-Ile62 and fH-Val62, respectively. These
experiments consistently show that fH-Ile62 is significantly more active than fH-Val62 as a
cofactor for the fI-mediated proteolysis of surface bound C3b (P=0.0025; two-tailed
unpaired T test). From these experiments it was estimated that the dose of fH-Val62 needed
to achieve 50% fI-mediated inactivation of C3b is 1.6-1.8 fold that required when fH-Ile62 is
used.
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Decay accelerating activity of the alternative pathway C3-convertase
To measure AP convertase decay accelerating activity of the fH-Ile62 and fH-Val62 variants,
sheep erythrocytes were coated with AP convertase (C3bBb) and incubated with increasing
amounts of purified fH-Ile62 or fH-Val62 in the absence of fI. Residual AP convertase on the
sheep erythrocytes was determined by measuring erythrocyte lysis after lytic pathway
reconstitution (see Materials and Methods). In three independent experiments, these
hemolytic assays showed that fH-Ile62 and fH-Val62 have equivalent decay accelerating
activity (Figure 5a). Independent confirmation of this finding was sought using Biacore
(Figure 5b). AP C3 convertase was assembled on a C3b-coated chip and allowed to decay
naturally for 160 seconds; fH-Ile62 or fH-Val62 at a concentration of 73nM were then flowed
over the chip. Binding of fH and accelerated convertase decay occurred simultaneously.
Following dissociation of fH from the surface, remaining convertase was measured, this was
identical for each fH variant. Note the increased binding of fH-Ile62 to the surface in
agreement with Figure 2a.
Competition between fH and fB for binding to C3b
From the experiments presented above it is clear that the differences in binding affinity for
C3b of the fH-Ile62 and fH-Val62 variants affect their capacity to function as cofactor for fI
in the proteolysis of C3b. To explore whether these differences in affinity also influence the
ability of fH to prevent formation of the C3 proconvertase by competing with fB for binding
to C3b competition assays were performed on Biacore. We first showed, in keeping with
previous reports, that fH does not accelerate decay of the pre-formed proconvertase C3bB
(Figure 6a). When fB together with increasing amounts of fH was flowed over a C3b
surface, competition between fB and fH for binding to C3b was apparent from the fH-
dependent decrease in the formation of proconvertase measured following dissociation of fH
(Figure 6b). Next, fB was flowed over C3b and binding competed using identical amounts
of the fH-Ile62 and fH-Val62 variants. As expected, fH-Ile62, shown to bind better to C3b,
was a more efficient competitor and caused a small but consistent decreased formation of
the proconvertase (Figure 6c). These data illustrate that the increased C3b-binding affinity of
the fH-Ile62 variant makes it not only a better cofactor for the fI-dependent inactivation of
C3b, but also a more efficient inhibitor of the formation of the C3 proconvertase.
Combined effects of the fH Val62Ile and fB Arg32Gln polymorphisms in the formation of
the AP C3 convertase
Previously, we have characterized the common fB polymorphism, fB-Arg32/fB-Gln32/fB-
Trp32, and found that the AMD-protective allele fB-Gln32 had decreased affinity for C3b
compared with the fB-Arg32 and fBTrp32 alleles. SPR comparison revealed markedly
different proenzyme formation activities; fB-Arg32 bound C3b with 4-fold higher affinity
than fB-Gln32, and formation of activated convertase was enhanced (29). Here we tested
combinations of these two variants of fB with the two variants of fH characterised above in
order to explore the consequences of different combinations of variant components and
regulators. In haemolytic assays, we found that the combinations complemented each other
as predicted from their individual activities (Figure 7). The fH-Ile62-fB-Gln32 combination
was the least lytic and the fH-Val62-fB-Arg32 combination the most lytic (Figure 7).
Calculated EC50s were 4.3nM and 3.5nM (for the fH-Ile62-fB-Gln32 and fH-Val62-fB-Gln32
combinations, respectively) and 3nM and 2.1nM (for the fH-Ile62-fB-Arg32 and fH-Val62-
fB-Arg32 combinations, respectively). Differences in the EC50 were statistically significant
between the combinations fH-Val62-fB-Arg32 and fH-Ile62-fB-Gln32 (P<0.001); fH-Val62-
fB-Arg32 and fH-Ile62-fB-Arg32 (P=0.004); and fH-Val62-fB-Gln32 and fH-Ile62-fB-Gln32
(P=0.034). P values were calculated using a two-tailed unpaired T test. No significant
differences were observed between the combinations fH-Val62-fB-Gln32 and fH-Ile62-fB-
Arg32.
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Discussion
Factor H (fH) plays a key role in regulating the alternative pathway by acting as a cofactor
for fI-mediated cleavage of C3b to iC3b, by accelerating the dissociation of the alternative
pathway C3 convertases and by competing with factor B for binding to C3b in
proconvertase formation (9). All these activities are mediated by the interaction between fH
and C3b. Functional studies using truncated molecules have demonstrated that fH possesses
binding sites for C3b located at the N-terminus (SCR1-4), the C-terminus (SCR19-20) and
in the middle of the molecule (SCR7) (30, 31). The C3b-binding sites at the C-terminal and
N-terminal ends are well characterized, whereas that in SCR7 is a very weak binding site of
unknown function. The C3b-binding site in SCR19-20 shows the highest affinity for C3b
and plays a critical role in recognition of foreign surfaces by fH. At the other end of the
molecule, the C3b-binding site in SCR1-4 is essential for the regulatory activities of fH as it
carries the fI-mediated cofactor and decay-accelerating activities of fH. Deletion
mutagenesis studies have demonstrated that the N-terminal four SCRs are necessary and
sufficient for these activities of fH, suggesting that multiple interactions occur between C3b
and the N-terminal region of fH (32, 33).
Here we report that the Val62Ile substitution in SCR1 of fH increases its affinity for C3b; as
a consequence, when compared to fH-Val62, fH-Ile62 competes more efficiently with fB for
C3b binding in proconvertase formation and acquires enhanced cofactor activity for the
factor-I mediated cleavage of C3b proteolysis; however, its decay accelerating activity is not
altered. These findings show that fH-Ile62 is a better AP convertase inhibitor and provide an
explanation for the association of the fH-Ile62 variant with protection in three distinct
disorders linked by AP dysregulation. The fact that the Val62Ile substitution affects binding
to C3b but not decay accelerating activity suggests that different regions in fH may be
involved in binding C3b/cofactor activity and in decay accelerating activity.
SCR1 is necessary for both cofactor and decay accelerating activities (32, 33). Our findings
imply that the C3b-binding site in SCR1 is not directly involved in decay accelerating
activity and that SCR1 may contain distinct, although perhaps overlapping, sites for cofactor
and decay accelerating activities. This scenario dictates that the interactions of fH with C3b
and with C3bBb are structurally distinct. Previously, we showed that the aHUS-associated
fB mutation, K323E, located remote from the C3b-fB interaction site, makes the C3bBb
convertase resistant to decay by decay accelerating factor (DAF) and fH (24, 34). The
mutation apparently affects a complement regulator binding site in the von Willebrand
factor type A (vWA) domain of fB (24). We have also previously showed that DAF-SCR2
interacts with Bb, whereas DAF-SCR4 interacts with C3b in the C3bBb complex (27). From
comparison with DAF it is likely that decay accelerating activity of fH also requires binding
to both Bb and C3b. We suggest that there are two distinct binding sites in SCR1, one
including the Val62Ile fH polymorphism that is necessary for cofactor activity, and a second
that binds fB at, or close to, K323 in fB that is essential for decay accelerating activity. We
also postulate that fH has a C3b binding site in SCR3/SCR4 that contributes to both cofactor
and decay accelerating activities.
Overwhelming evidence has associated MPGN2/DDD, aHUS and AMD with mutations or
polymorphisms in the
CFH
gene and provided conclusive data that AP dysregulation is a
unifying pathogenetic feature of these diverse conditions (35). However, only MPGN2/DDD
and AMD have pathological similarities. Indeed, occasionally, they occur in the same
patient (36). The hallmark of AMD is drusen, a complex, complement-containing material
that accumulates beneath the retinal pigmented epithelium; in MPGN2/DDD, accumulation
of a drusen-like C3 and electron-dense material occurs along the glomerular basement
membrane (GBM). In contrast to these ‘debris-associated’ conditions, aHUS is characterized
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by renal endothelial cell injury and thrombosis (thrombotic microangiopathy), resulting in
haemolytic anaemia, thrombocytopenia and renal failure. Consistent with these differences,
distinct functional alterations in fH associate with pathogenesis in these disorders. Mutations
or polymorphisms altering the C3b/polyanions-binding site located at the C–terminal region
of fH are strongly associated with aHUS because they impair the capacity of fH to protect
host cells but have no effect on fluid-phase fH activities. On the other hand, mutations that
disrupt the capacity of fH to inhibit complement activation in plasma result in massive
activation of C3 that causes MPGN2/DDD. This clear genotype-phenotype correlation
contrasts with the association of the fH Val62Ile polymorphism, associated with lower risk
for the three diseases (18, 22).
To understand why the fH-Ile62 variant confers protection from aHUS, MPGN2/DDD and
AMD, we purified to homogeneity both fH-Val62 and fH-Ile62 variants and compared in a
series of functional assays for potential effects on proenzyme formation and cofactor and
decay accelerating activities in fluid phase and on cell surfaces. Using four different
experimental approaches, we showed that fH-Ile62 binds better to C3b, competes better with
fB to reduce proenzyme formation, and performs more efficiently as a cofactor of fI in the
proteolysis of fluid phase and surface-bound C3b. These enhanced activities explain the
protective role of fH-Ile62 both in diseases associated with fluid phase complement
dysregulation, like MPGN2/DDD, and membrane-restricted dysregulation as is the case in
aHUS.
One important conclusion from this report is that the protective effect of the fH-Ile62 variant
is subtle, with alterations in activities of between 20% and 50% depending on the assay
used. This is consistent with the recent observation (37) that the Val62Ile polymorphism
causes a very minor perturbation in the structure of SCR1, this contrasts with the larger
structural disturbance caused by an aHUS-associated mutation (Arg53His) which has
detrimental consequences on the functional activities of fH. Nevertheless, the very nature of
the complement system will amplify these small effects. Further, as we show here by
combining known functional variants in fB with fH-Ile62 and fH-Val62, particular
combinations of variants in components and regulators will result in very different AP
characteristics, markedly affecting formation and regulation of the AP C3 convertase in
plasma and on cell surfaces. Identification of individuals carrying ‘high risk’ or ‘low risk’
combinations (‘complotypes’) of the polymorphic complement component and regulator
variants will be of great importance for prediction of disease risk and may also help in
diagnosis and choice of treatment for diseases involving complement dysregulation.
Materials and Methods
Purification of complement components and activation fragments
Normal healthy volunteers were screened for mutations/polymorphisms in the
CFH
gene by
automatic DNA sequencing of PCR amplified fragments. Genomic DNA was prepared from
peripheral blood cells according to standard procedures (23). Each exon of the
CFH
gene
was amplified from genomic DNA by using specific primers derived from the 5′ and 3′
intronic sequences as described (14). Automatic sequencing was performed in an ABI 3730
sequencer using a dye terminator cycle sequencing kit (Applied Biosystems, Foster City,
CA).
Factor H was purified from individuals homozygous for either the fH-Ile62 and fH-Val62
variants who were identical at all other amino acid residues. Fresh EDTA plasma (100 ml)
was precipitated with 7% polyethylene glycol 8000 overnight at 4°C. The precipitate was re-
dissolved in PBS, dialysed extensively against 20 mM Tris-HCl (pH 7.4), 50 mM NaCl, 5
mM EDTA and applied to a heparin-Sepharose column (Heparin 6B Fast Flow, Amersham)
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equilibrated in the same buffer. The proteins bound to the column were eluted with a
100-200 mM NaCl gradient in 20mM Tris-HCl, pH 7.4, 5mM EDTA. Fractions containing
fH were identified by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-
PAGE), pooled, dialysed against 20 mM Tris-HCl; pH 7.6, 20 mM NaCl and 10 mM EDTA
and applied to a DEAE-Sephacel column. Bound proteins were eluted with a 20-300 mM
NaCl gradient. Fractions containing fH were identified by SDS-PAGE, pooled and further
purified by gel filtration on a Superose™ 6 10/300 column (GE Healthcare). The fH peak
fractions were pooled and stored frozen at −70°C. The fH used in haemolysis assays and
Biacore studies was purified by affinity chromatography using immobilised anti-fH (35H9;
in house). Protein was eluted with 0.1M Glycine/HCl pH 2,5 and gel filtered into assay
buffer using a Superdex 200 10/300 column (GE Healthcare) immediately prior to analysis.
The purity of the final preparations was confirmed by SDS-PAGE. Preparations of fH-Ile62
and fH-Val62 were obtained without any detectable contaminants or aggregates (Figure 1b).
C3 and Factor B were purified by affinity chromatography and gel filtration as described
previously (24). Concentration of proteins was assessed using absorbance at A280,
molarities were calculated using an extinction coefficient for fH of 1.95 (25), for fB of 1.43
and for C3 of 0.98 (coefficients were obtained by using Protean Software, DNAStar). C3b
was generated by limited digestion with trypsin or convertase as previously described (24,
26) and re-purified by ion exchange and/or gel filtration as described above (GE
Healthcare). C3b was obtained without any detectable contaminants or aggregates. Factor I,
factor D and properdin were purchased from Comptech (Tyler, TX).
ELISA C3b–binding Assay
The binding of fH variants to surface-bound C3b was determined by ELISA. In a 96-well
polystyrene microtiter plate, C3b (5 μg/ml) in coupling buffer (0.1 M NaHCO3 pH 9.5) was
coated overnight at 4°C. The plate was blocked with washing buffer (20 mM Tris, 150 mM
NaCl and 0.1% Tween 20) with 1% Bovine Serum Albumin for 1 hour at room temperature
(RT). After washing, serial dilutions of fH variants (10μg/ml) in blocking buffer containing
150 mM NaCl, 5mM EDTA, were added and incubated with surface-bound C3b for 2 hours
at 37°C. After washing, the plate was incubated with anti-fH monoclonal antibody (mAb)
35H9 (in house) in blocking buffer, for 1 hour at RT, and then with a secondary antibody
coupled with horseradish peroxidase (DAKO). Colour reaction was developed with o-
phenylene-diamine (DAKO) and absorbance measured at 492nm. fH preparations used in
the ligand assay were quantified in duplicate in the same ELISA plate using immobilised
polyclonal anti-fH antibody to capture fH and the same anti-fH mAb, 35H9, and secondary
antibodies to measure the amount of protein. Concentrations of fH were calculated from
curves obtained using purified standard samples.
Biosensor Analysis
Kinetic analyses (Figure 2) were carried out on a Biacore T100, all other analyses were
carried out using a Biacore 3000 (GE Healthcare). To measure affinity, fH was amine
coupled to a CM5 (carboxymethylated dextran) chip as instructed by the manufacturer
(NHS/EDC coupling kit). Number of RUs loaded for both variants were 1004RU (fH Ile62)
and 1003RU (fH Val62). C3b was flowed across the surface at different concentrations and
bound protein was allowed to decay naturally, the buffer was 10mM Hepes pH7.4, 100mM
NaCl, 0.005% Surfactant P20. Data were collected at 25°C at a flow rate of 30μl/minute and
were double-referenced (data from reference cell and blank inject were subtracted) to
control for bulk refractive index changes. To calculate Kd values (Figure 2) we repeated this
experiment on three different surfaces: twice with C3b flowing, and once with hydrolysed
C3 flowing. Pooling the data from different runs is difficult. However, the ratio of the
derived Kd values was the same for each run as follows: fH-Ile62 was 0.77, 0.78 or 0.8 fold
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lower than the fH-Val62 form. We flowed C3b over the surface (rather than fH over C3b) in
order to minimise the avidity effects seen when flowing fH over the surface. In order to
obtain the best quality data, the C3b was gel-filtered prior to use to remove any aggregates
and then used in the experiment without further concentration. The C3b needed to be at a
very high concentration pre-filtration in order to achieve 1mg/ml post-filtration, this was the
maximum concentration that we could use without precipitating the protein pre-filtration.
Although we did not achieve saturation in these experiments, in each case the concentration
of C3b used exceeded the Kd value (2.2-fold for fH-Ile62 and 1.7-fold for fH-Val62).
In the following experiments the buffer was 10mM Hepes pH 7.4, 150mM NaCl, 1mM
Mg2+. To test the decay activity of fH (Figure 5), fB at 100μg/ml (1.1μM) and fD (2μg/
mL), were flowed across the C3b surface to form the AP C3 convertase as previously
described (27). The fH variants were subsequently flowed across the C3b surface at 11.3μg/
ml (73nM) and decay was monitored. To examine competition between fH and fB for
binding to C3b (Figure 6), both proteins were mixed at the indicated concentrations and
flowed at 30μl/min across the C3b surface in the absence of fD. To determine whether fH
accelerated decay of the proenzyme, fH was flowed over the surface subsequent to the fB
injection rather than being premixed.
Cofactor activity for fI-mediated proteolysis of fluid phase C3b
The fluid-phase cofactor activity of factor H was determined in a C3b proteolysis assay
using purified proteins. In brief, C3b, fH and fI were mixed in 10mM Hepes pH 7.5, 150mM
NaCl, 0.02% Tween 20 at final concentrations of 50 μg/ml (263nM), 4 μg/ml (25.8nM) and
10 μg/ml (114nM), respectively. Mixtures were incubated at 37°C in a water bath and 20μl
aliquots were collected at 2.5, 5, 7.5 and 10 minutes. The reaction was stopped by the
addition of 3μl of SDS sample buffer (2% SDS, 62.5mM Tris, 10% Glycerol, 0.75%
Bromophenol Blue). Samples were analyzed in 10% SDS-PAGE under reducing conditions.
Gels were stained with Coomassie brilliant blue R-250 (Bio Rad) and proteolysis of C3b
determined by measuring the cleavage of the α’-chain using a GS-800 calibrated
densitometer (BioRAD) and the MultiGauge software package (FUJIFILM). The C3b β-
chain was used as an internal control to normalize the % of cleavage between samples.
Percentage of cleavage was determined by the ratio between α′chain / βchain of C3b and
setting as 0% the amount of α’-chain at time 0.
Factor H-dependent haemolysis assays
NHS was sequentially depleted of fB and fH (NHSΔBΔH) by flowing over immobilised
anti-Bb (JC1 mAb; in house) and immobilised anti-fH (35H9; in house) affinity columns in
complement fixation diluent (CFD; Oxoid), undiluted depleted serum was pooled and used
in haemolysis assays as described below. Antibody-coated sheep erythrocytes (EA) were
prepared by incubating sheep E (2% v/v) with Amboceptor (1/1000 dilution; Behring
Diagnostics) in complement fixation diluent (CFD; Oxoid) for 30 minutes at 37°C, EA were
washed and resuspended at 2% (v/v) in CFD. To deposit C3b on the E surface (E-C3b),
equal volumes of EA and NHSΔBΔH (8% v/v) were incubated at 37°C for 10 minutes, the
C5 inhibitor (OmCI; 6μg/ml; (28) was added to block the terminal pathway).
To test fH dependent decay accelerating activity, washed E-C3b cells were resuspended to
2% (v/v) in AP buffer (5 mM sodium barbitone pH 7.4, 150 mM NaCl, 7 mM MgCl2, 10
mM EGTA) and AP convertase was formed on the cell surface by incubating with fB 42μg/
ml (0.46μM) and fD (0.4μg/ml) at 37°C for 15 minutes. 1/25 volume of PBS/0.25M EDTA
was added to prevent further enzyme formation and cells (50μl) were mixed and incubated
with 50μl of fH (serial dilution from 15.4μg/ml (99nM)) in PBS/10mM EDTA for 12
minutes. Lysis was developed by adding 50μl NHSΔBΔH (4%, v/v) in PBS/EDTA and
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incubating at 37°C for 20 minutes. To calculate lysis, cells were pelleted by centrifugation,
and hemoglobin release was measured by absorbance at 415 nm. Control incubations
included 0%lysis (buffer only) and 100%lysis (0.1% Nonidet-P40). Percentage lysis
100*(A415 test sample-A415 0% control)/(A415 100% control-A415 0% control).
To test fH cofactor activity, washed EA-C3b cells were resuspended to 2% in AP buffer and
incubated with an equal volume of different concentrations of fH as indicated and constant
fI (2.5μg/mL) for 7 minutes at 22°C. After three washes in AP buffer, 50μl cells (2%) were
mixed with 50μl of 70μg/ml fB (0.75μM; fB32R or fB32Q) and fD (0.4μg/ml) and incubated
for 10 minutes at 22°C to form convertase on residual C3b (EA-C3bBb). Lysis was
developed by adding 50μl NHSΔBΔH (4%, v/v) in PBS/EDTA and incubating at 37°C for
20 minutes. Percentage lysis was calculated as described above. To assess the effect on lysis
by combining different polymorphic variants of fB and fH, the above two assays were
combined and modified as follows. EA-C3b cells were incubated with 80ng/ml (0.5nM) fH-
Ile62 or fH-Val62 variant and 2.5μg/ml fI for 7 minutes at 22°C. Washed cells were
incubated as described above with different concentrations of fBArg32 or fBGln32, fD and
properdin (1μg/ml) and lysis was developed using NHSΔBΔH.
Acknowledgments
This work was supported by MRC Project Grant Ref 84908 (to CLH and BPM), Ministerio de Ciencia e Innovación
Ref SAF 2005-00913 (to SRdeC) the CIBER de Enfermedades Raras and Fundación Renal Iñigo Alvarez de
Toledo (to SRdeC). We thank the blood donors for their invaluable contribution to the project.
Abbreviations
CFH gene encoding factor H
AP alternative pathway
CP classical pathway
LP lectin pathway
MAC membrane attack complex
fH Factor H
SCR short consensus repeats
MPGN2/DDD membranoproliferative glomerulonephritis type II or dense deposit
disease
aHUS atypical haemolytic uraemic syndrome
AMD age-related macular degeneration
SPR surface plasmon resonance
fI factor I
fB factor B
NHS normal human serum
CFD complement fixation diluent
EA antibody-coated sheep erythrocytes
DAF decay accelerating factor
vWA von Willebrand factor type A
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Figure 1. ELISA of fH-Ile62 and fH-Val62 binding to C3b
(a) Interaction between serial dilutions of purified fH-Ile62 (open circles) or fH-Val62 (filled
circles) with C3b deposited in 96-well plates is expressed as Abs492. Means ± S.D. of three
independent experiments are shown. Inset panel shows the double reciprocal plot of the fH-
Ile62 (open circles) and fH-Val62 (filled circles) C3b-binding curves. Multiple linear
regression analysis revealed significant differences between Val62 and Ile62 binding to C3b
(P<0.0001).
(b) SDS-PAGE illustrating the fH-Ile62 and fH-Val62 purified from the plasma of
homozygote carriers as described in Materials and Methods and then gel filtered to remove
aggregates.
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Figure 2. SPR analysis of fH-Ile62 and fH-Val62 binding to C3b
(a) Identical amounts of fH were immobilised onto a CM5 chip (fH-Ile62 1004RU
immobilised; fH-Val62 1003RU immobilised). C3b (2.2μM-8.6nM; 1/2 serial dilution) was
flowed across the fH-Ile62 or fH-Val62 surfaces in 10mm Hepes pH 7.4, 100mM NaCl,
0.005% surfactant P20. Data from a reference cell was subtracted to control for any bulk
changes in refractive index. Sensorgrams resulting from fH-Ile62 are solid lines and fH-
Val62 are dotted lines; identical concentrations are illustrated for the two variants.
(b) Steady state analysis of the data in these buffer conditions indicate the affinities for C3b
are: KD fH-Ile62: 1.03μM, KD fH-Val62: 1.33μM. The standard errors (SE) in the fits are
0.14μM for fH-Val62 and 0.12μM for fH-Ile62.
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Figure 3. Cofactor activity of fH-Ile62 and fH-Val62 variants in the proteolysis of fluid phase C3b
(a) SDS-PAGE of C3b proteolysis. C3b, fH and fI were incubated for the times indicated,
the reaction was stopped by the addition of SDS sample buffer. Samples were analyzed by
SDS-PAGE under reducing conditions and gels were Coomassie-stained.
(b) Densitometric analysis of C3b proteolysis. Fluid phase cofactor activity was measured be
examining C3b cleavage at 2.5, 5, 7.5 and 10 minutes reaction for both fH-Ile62 (open
circles) and fH-Val62 (filled circles) variants. Percentage of cofactor activity was determined
by the ratio of cleaved α′chain:βchain, normalized to 0% proteolysis of control samples.
Inset panel shows the double reciprocal plot of the fH-Ile62 (open circles) and fH-Val62
(filled circles) of the cofactor activity curves. Multiple linear regression analysis revealed
significant differences between the slopes for fH-Val62 and fH-Ile62 cofactor activities
(P=0.0012).
(c) Densitometric analysis of C3b proteolysis from an independent set of assays at 6 minutes
incubation time. Difference in percentage of cofactor activity between fH-Val62 and fH-Ile62
was significant (P<0.001).
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Figure 4. Cofactor activity of fH-Ile62 and fH-Val62 variants in the proteolysis of surface-bound
C3b
The ability of the fH variants to mediate fI-catalysed inactivation of surface-bound C3b was
assessed using a haemolysis assay. C3b was deposited on the surface of sheep E using the
classical pathway as described in Methods. E-C3b were incubated in AP buffer with
different concentrations of fH-Ile62 (open circles) or fH-Val62 (filled circles) and constant fI
for 7 minutes at 22°C. Cells were washed and AP convertase was formed using purified fB
and fD. Lysis was developed in EDTA-containing buffer using serum depleted of fB and fH.
Percent lysis was calculated for each concentration of fH. The log10 of fB concentration
(final concentration in the incubation) was plotted on the
x
axis, and percentage lysis on the
y
axis. Data points represent mean ±SD of 3 determinations. The curves were fitted by using
nonlinear regression analysis to calculate the EC50. There are significant differences
(P=0.0025) between the EC50 values corresponding to the fH-Ile62 (14nM) and fH-Val62
(22.6nM) variants.
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Figure 5. Decay accelerating activity of fH-Ile62 and fH-Val62 variants on surface-bound AP
convertase
The ability of the fH variants to accelerate decay of the AP convertase, C3bBb, was assessed
using haemolysis assays with convertase coated sheep E as target (a), and in real time using
SPR (b). (a) C3b was deposited on the surface of sheep E using the classical pathway as
described in Methods. AP convertase was formed on the cell surface using purified fB and
fD, convertase formation was stopped after 15 minutes using EDTA. E-C3bBb were
incubated in EDTA with different concentrations of fH-Ile62 (open circles) or fH-Val62
(filled circles) for 12 minutes to allow decay of the convertase and lysis was developed
using serum depleted of fB and fH. Percent lysis was calculated for each concentration of
fH. (b) AP convertase was formed on the surface of a C3b-coated Biacore chip by flowing
fB and fD over the surface. Convertase decayed naturally for 160s prior to injection of either
fH variant (73nM). Change in RU (y-axis) during the fH injection represents the combined
effect of fH binding to the surface and to C3bBb, and loss of Bb from the convertase due to
fH-mediated accelerated decay. Despite enhanced binding of fH-Ile62 to the surface (grey
line), an identical amount of Bb was decayed from the surface as measured following
complete dissociation of fH from the chip surface.
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Figure 6. Competition between fH and fB for binding to C3b
(a) Proconvertase was formed on the surface of a C3b-coated Biacore chip by flowing fB,
this was allowed to decay naturally for a short time before injection of fH as indicated. As
expected, fH did not accelerate decay of the proenzyme. The binding profile of fH on the
C3b surface only (no fB injected) is illustrated in grey for comparison. (b) In order to
demonstrate competition between fB and fH for binding to the C3b-coated surface, fB
(662nM) was flowed across the C3b-coated surface alone (black line), or was premixed with
26 or 66nM fH (dotted grey and solid grey lines respectively) before injection. Note that the
change in RU (y-axis) represents the sum of both fB and fH binding to the surface.
Decreased proconvertase formation is evident with increasing fH. (c) In order to analyse
differential effects of fH-Ile62 and fH-Val62 on proconvertase formation, 132nM of either
variant was premixed with fB (338nM) and injected over the surface. Comparison of
binding curves (following dissociation of fH from the surface) with fB binding in the
absence of any fH demonstrates that both fH variants prevent proconvertase formation and
that the fH-Ile62 variant is more effective.
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Figure 7. Hemolytic activity of different fH and fB variant combinations
To test the combined effect of the fH-Ile62, fH-Val62 and the fBArg32, fBGln32 variants,
C3b was deposited on the surface of sheep E using the classical pathway as described in
Methods. E-C3b were incubated in AP buffer with 1nM of fH-Ile62 or fH-Val62 (final
concentration) and constant fI for 7 minutes at 22°C. Cells were washed and AP convertase
was formed using different concentrations of purified fBArg32 or fBGln32, and constant fD
and properdin. Lysis was developed in EDTA-containing buffer using serum depleted of fB
and fH. Percent lysis was calculated for each concentration of fH.
The log10 of fB concentration (final concentration in the incubation) was plotted on the
x
axis, and percentage lysis on the
y
axis. Data points represent mean ±SD of 3
determinations. The curves were fitted by using nonlinear regression analysis to calculate
the EC50. Two-tailed unpaired T test showed significant differences in the EC50 between
the combinations fH-Val62-fB-Arg32 (filled circles) and fH-Ile62-fB-Gln32 (open triangles)
(P<0.001); fH-Val62-fB-Arg32 (filled circles) and fH-Ile62-fB-Arg32 (open circles)
(P=0.004); and fH-Val62-fB-Gln32 (filled triangles) and fH-Ile62-fB-Gln32 (open triangles)
(P=0.034).
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