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C4d is a stable split product remnant of classical complement activation which becomes covalently bound to endothelium and basement membrane (1). Capillary deposition of complement C4d has been suggested to be a valuable marker for humoral rejection and endothelial C4d deposition in kidney allograft has been associated with inferior graft outcome (1-3). The detection of C4d in formalin-fixed, paraffin-embedded tissue has been documented to be valuable in the evaluation of various inflammatory diseases (4). Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adults and C4d immunohistochemical staining has been shown to be a very useful tool for MN (5).
In the past, most publications have used polyclonal antibodies against C4d. However, polyclonal antibodies are known to vary from batch to batch. C4d [A24-T] is a rabbit monoclonal antibody suitable for formalin-fixed paraffin-embedded tissues.
0.1 ml, 0.5 ml, 6.0 ml
Internal sequence of human C4
Renal allograft tissue
1. Troxell ML, et al. Comparison of C4d immunostaining methods in renal allograft biopsies. Clin J Am Soc Nephrol. 2006 May; 1(3):583-91.
2. Regele H, et al. Endothelial C4d deposition is associated with inferior kidney allograft outcome independently of cellular rejection. Nephrol Dial Transplant. 2001 Oct; 16(10):2058-66.
3. Böhmig GA, et al. Capillary C4d deposition in kidney allografts: a specific marker of alloantibody-dependent graft injury. J Am Soc Nephrol. 2002 Apr; 13(4):1091-9.
4. Magro CM, Dyrsen ME. The use of C3d and C4d immunohistochemistry on formalin-fixed tissue as a diagnostic adjunct in the assessment of inflammatory skin disease. J Am Acad Dermatol. 2008 Nov; 59(5):822-33.
5. Espinosa-Hernández M, et al. C4d as a diagnostic tool in membranous nephropathy. Nefrologia. 2012 May 14; 32(3):295-9.
6. Center for Disease Control Manual. Guide: Safety Management, NO. CDC-22, Atlanta, GA. April 30, 1976 “Decontamination of Laboratory Sink Drains to Remove Azide Salts.”
7. Clinical and Laboratory Standards Institute (CLSI). Protection of Laboratory Workers from Occupationally Acquired Infections; Approved Guideline-Fourth Edition CLSI document M29-A4 Wayne, PA 2014.