Complement activation is associated with common rheumatic diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and systemic vasculitis. Evidence linking complement activation to these diseases includes the presence of complement deposition in affected tissues, decreased levels of complement proteins and high levels of complement activation fragments in the blood and/or synovial fluid of patients with these diseases, as well as data from experimental models. Eculizumab, a monoclonal antibody that inhibits the complement component C5, is now approved for the treatment of rare conditions involving complement hyperactivation, and the success of this therapy has renewed interest in understanding the utility of complement inhibition in rheumatological practice, particularly for SLE. For example, inhibiting C5 is a potential means of reducing glomerular inflammation in lupus nephritis or treating thrombotic microangiopathy in SLE. The complement system is one of multiple mediators of tissue injury in complex diseases such as SLE, and identifying the disease context in which complement activation has a predominant role is a challenge. An added difficulty in RA is identifying a role for therapeutic complement inhibition within the diverse treatment modalities already available. In this Review, evidence for the therapeutic potential of complement manipulation in rheumatology practice is evaluated.

补体激活与常见的风湿性疾病有关，例如系统性红斑狼疮（SLE），类风湿性关节炎（RA）和系统性血管炎。将补体激活与这些疾病联系起来的证据包括受影响的组织中存在补体沉积，这些疾病患者的血液和/或滑液中补体蛋白水平降低和补体激活片段水平高以及实验模型数据。依库丽单抗（Eculizumab）是一种抑制补体成分C5的单克隆抗体，现已被批准用于治疗罕见的涉及补体过度活化的疾病，该疗法的成功重新引起了人们对了解补体抑制在风湿病实践中的实用性的兴趣，特别是对于SLE。例如，抑制C5是减轻狼疮性肾炎中肾小球炎症或治疗SLE中血栓性微血管病的潜在手段。补体系统是复杂疾病（如SLE）中组织损伤的多种介体之一，而要确定其中补体激活起主要作用的疾病环境是一个挑战。RA的另一个困难是在已经存在的多种治疗方式中确定治疗性补体抑制作用。在这篇综述中，评估了风湿病实践中补体操纵的治疗潜力的证据。并确定其中补体激活起主要作用的疾病背景是一个挑战。RA的另一个困难是在已经存在的多种治疗方式中确定治疗性补体抑制作用。在这篇综述中，评估了风湿病实践中补体操纵的治疗潜力的证据。并确定其中补体激活起主要作用的疾病背景是一个挑战。RA的另一个困难是在已经存在的多种治疗方式中确定治疗性补体抑制作用。在这篇综述中，评估了风湿病实践中补体操纵的治疗潜力的证据。