Expertscape's Brendan McAdams speaks with Expertscape World Expert Dr. Richard J. H. Smith of the University of Iowa Carver College of Medicine about the latest research into Complement-mediated renal disease (CMRD).

"Complement-mediated renal diseases" are a group of disorders that affect kidney function. They include atypical hemolytic uremic syndrome and C3 glomerulopathy (which itself includes dense deposit disease and C3 glomerulonephritis). Each of these disorders arises from abnormal regulation of the "Complement" system of proteins, which is an ancient part of the immune system.
What do you consider to be the most significant advancement in research into Complement-mediated renal diseases, and what has that impact been?
Dr. SmithA better understanding of complement deregulation in disease and the development of therapies that target complement at different sites to restore complement control.
Make a prediction for us. What do you think will be the next big discovery in CMRD and what will that mean for those afflicted?
Dr. SmithMultiple different anti-complement agents that permit precision treatment based on the type and degree of complement deregulation – rather like antibiotics, which can be selected based on the causative bacterial infection.
How did you get involved in the CMRD field?
Dr. SmithOne of my daughters developed an ultra-rare complement-mediated renal disease.
Do you have any specific advice for those now entering healthcare, and particularly those focused on Complement-mediated renal diseases?
Dr. SmithFollow your passion and believe in your dreams. It is a marathon, not a sprint.
What are the most important questions to ask about CMRD?
Dr. SmithAs new therapies are developed to curb complement dysregulation, we gain new insights into the complexity and redundancy of complement system.
What are you working on now, and what to you hope to discover?
Dr. SmithWe are working on identifying better biomarkers of complement activity in order to predict outcome in persons with complement deregulation.
Our users may wonder: "There are a lot of EXPERTS near me. How do I know my Complement disorder is severe enough that I should consider traveling a distance to see a world expert?
Dr. SmithActually, there are few EXPERTS in complement dysregulation. We have been doing research in this area for over 20 years and have a team of experts to offer the most thorough analysis of the complement system for patients with C3 glomerulopathy and atypical hemolytic uremic syndrome in North America.
Here's a chance to brag about your institution. What do you like about working at the University of Iowa Carver College of Medicine?
Dr. SmithThe University of Iowa - Carver College of Medicine is an outstanding research environment with outstanding colleagues that support and encourage out-of-the-box thinking.
Should the public be encouraged by the progress being made in the field of Complement-mediated renal diseases?
Dr. SmithYes, definitely. There are multiple clinical trials on-going for C3 glomerulopathy, so for persons with this ultra-rare and once untreatable disease, the future looks very good.
What makes your work in CMRD so rewarding/challenging/difficult?
Dr. SmithC3 Glomerulopathy is a multifaceted disease. This complexity makes the research challenging and stimulating. In addition, over the past 20+ years, we have brought together families affected by C3 Glomerulopathy for annual C3G Family Meetings in Iowa City. Persons come from all over the world and over time, an "international C3G family" has evolved. During these meeting, persons living with C3G on a daily basis can interact with scientists working on their disease. This incredibly powerful motivator for scientists, who realize the immense and personal impact of their research.
What do you do when you're not focused on CMRD?
Dr. SmithSpend time with my lovely wife of 38 years.
Thank you, Dr. Smith.
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