Pyrrolopyrimidine amines as complement inhibitors
Disclosed are compounds of formula (I), and pharmaceutically acceptable salts thereof, which are inhibitors of the complement system. Also provided are pharmaceutical compositions comprising such a compound, and methods of using the compounds and compositions in the treatment or prevention of a disease or condition characterized by aberrant complement system activity.
1 . A compound represented by Formula (I), or a pharmaceutically acceptable salt thereof:
wherein, independently for each occurrence:
X is a bond or C(R X ) 2 ;
Y is a bond, C(R Y ) 2 , or —N(R b )—;
G is S or C(R 3 ) 2 ;
R a and R b are each independently H or (C 1 -C 6 )alkyl;
R 1 represents optionally substituted aryl or heteroaryl;
R 2 represents
R 3 is independently for each occurrence H, halogen, —CN, —NH 2 , —CH 2 NH 2 , (C 1 -C 6 )alkoxy or (C 1 -C 6 )alkyl; or two vicinal occurrences of R 3 taken together with the carbon atoms to which they are bonded form an optionally substituted fused (C 3 -C 7 )cycloalkyl or (C 6 )aryl; or two geminal occurrences of R 3 taken together with the carbon atom to which they are bonded form an optionally substituted spiro (C 3 -C 7 )cycloalkyl; or two hominal occurrences of R 3 taken together with the carbon atoms to which they are bonded form an optionally substituted bridged (C 3 -C 7 )cycloalkyl;
R X is independently for each occurrence H, (C 1 -C 6 )alkyl, or (C 3 -C 7 )cycloalkyl;
R Y is independently for each occurrence H, (C 1 -C 6 )alkyl, or (C 3 -C 7 )cycloalkyl;
optional substituents on R 1 each independently represent halogen, —CN, —NO 2 , —OR 13 , —NR 13 R 14 , —C(O)R 13 , —C(O)OR 13 , —C(O)NR 13 R 14 , —OC(O)R 13 , —NR 13 C(O)R 14 , —OC(O)NR 13 R 14 , —OC(O)OR 13 , —NR 13 C(O)OR 14 , —NR 13 C(O)NR 13 R 14 , —OS(O) p (R 13 ), —SR 13 , —NR 13 S(O) p (R 14 ), or optionally substituted alkyl, alkenyl, alkynyl, haloalkyl, hydroxyalkyl, alkoxyalkyl, cycloalkoxyalkyl, aryloxyalkyl, aralkyl, heteroaralkyl, heteroaryl, aryl, aryloxy, cycloalkyl, (cycloalkyl)alkyl, heterocycloalkyl, or (heterocycloalkyl)alkyl;
or wherein two substituents on R 1 , taken together with the intervening atoms, form a ring;
R 13 and R 14 , independently for each occurrence, represent H or optionally substituted alkyl, haloalkyl, alkenyl, alkynyl, aryl, or heteroaryl;
p is 0, 1, or 2;
Z 3 represents N;
Z 4 represents N or CR 4Z ;
Z 5 represents N or CR 5Z ;
Z 6 represents N or CR 6Z ;
Z 7 represents N or CR 7Z ;
Z 8 represents C;
Z 9 represents N or C;
k is an integer from 1-4;
m is an integer from 1-3; and
each occurrence of R 4Z , R 5Z , R 6Z , R 7Z , R 2A independently represents H, halogen, —CN, —NO 2 , —OR 13 , —NR 13 R 14 , —C(O)R 13 , —C(O)OR 13 , —C(O)NR 13 R 14 , —OC(O)R 13 , —NR 13 C(O)R 14 , —OC(O)NR 13 R 14 , —OC(O)OR 13 , —NR 13 C(O)OR 14 , —NR 13 C(O)NR 13 R 14 , —OS(O) p (R 13 ), —SR 13 , —NR 13 S(O) p (R 14 ), or optionally substituted alkyl, alkenyl, alkynyl, haloalkyl, hydroxyalkyl, alkoxyalkyl, cycloalkoxyalkyl, aryloxyalkyl, aralkyl, heteroaralkyl, heteroaryl, aryl, aryloxy, cycloalkyl, (cycloalkyl)alkyl, heterocycloalkyl, or (heterocycloalkyl)alkyl; or
wherein an occurrence of R 6Z and an occurrence of R 7Z taken together with the intervening atoms form a ring.
2 . The compound of claim 1 , wherein Y represents C(R Y ) 2 .
3 . The compound of claim 1 , wherein Y represents CH 2 .
4 . The compound of claim 1 , wherein X represents a bond.
5 . The compound of claim 1 , wherein X represents CH 2 .
6 . The compound of claim 1 , wherein R 1 represents optionally substituted heteroaryl.
7 . The compound of claim 1 , wherein R 1 represents optionally substituted phenyl (e.g., 3-halophenyl, or 2,3-dihalophenyl), pyridinyl (e.g., 6-halopyridin-2-yl), or pyrazinyl (e.g., 6-halopyrazin-2-yl).
8 . The compound of claim 1 , wherein R 1 represents
9 . The compound of claim 1 , wherein R 1 represents
10 . The compound of claim 1 , wherein R 2 represents
11 . The compound of claim 10 , wherein R 2 represents
12 . The compound of claim 10 , wherein k represents 2.
13 . The compound of claim 1 , wherein R 2 represents
14 . The compound of claim 1 , wherein R 7Z represents —NR 13 R 14 .
15 . The compound of claim 1 , wherein R 7Z represents —NH 2 .
16 . The compound of claim 1 , wherein R 6Z represents —C(O)R 13 , —C(O)OR 13 , —C(O)NR 13 R 14 , or hydroxyalkyl.
17 . The compound of claim 1 , wherein R 5Z represents alkyl, halo, or —NR 13 R 14 .
18 . The compound of claim 1 , wherein R 1Z represents —CN, halo, haloalkyl, optionally substituted aryl, optionally substituted heteroaryl, optionally substituted alkyl, —C(O)R 13 , —SR 13 , —NR 13 R 14 , —OR 13 , —C(O)OR 13 , —C(O)NR 13 R 14 , or —NR 13 C(O)R 14 .
19 . The compound of claim 1 , wherein each occurrence of R 2A independently represents —CN, —NO 2 , halo, haloalkyl, optionally substituted aryl, optionally substituted heteroaryl, optionally substituted alkyl, optionally substituted alkenyl, optionally substituted hydroxyalkyl, —C(O)R 13 , —C(O)OR 13 , —NR 13 C(O)OR 14 , —SR 13 , —NR 13 R 14 , —OR 13 , —C(O)NR 13 R 14 , or —NR 13 C(O)R 14 .
20 . The compound of claim 1 , wherein G is C(R 3 ) 2 .
21 . The compound of claim 1 , having the structure of formula (Ia):
22 . The compound of claim 1 , wherein two vicinal occurrences of R 3 taken together with the carbon atoms to which they are bonded form an optionally substituted fused C 3 -cycloalkyl.
23 . The compound of claim 1 , wherein at least one occurrence of R 3 is halo.
24 . The compound of claim 1 , wherein at least one occurrence of R 3 is methyl.
25 . The compound of claim 1 , or a pharmaceutically acceptable salt thereof, selected from the following table:
#
Structure
#
Structure
20a
24a
19a
50f
3b
32f
4b
43a
9a
35f
1e
30f
6e
47g
7b
48d
21a
38e
27a
51g
25a
52f
26a
54g
8b
44a
28a
29f
10b
22c and 22d
11f
33e
12a
49c
34e
58c
13b
59c
14a
17f
15a
18a
37a
31f
218a
60c
223a
61a
224b
46g
225e
62c
226c
63d
219a
53d
227c
55a
228a
56g
57g
229c
159a
230a
160a
231g
171b
246b
172a
247d
173a
248d
161a
232a
174g
234a
175a
267c
176a
268b
169f
269c
177d
274g
178d
276g
162g
277a
163g
278g
164a
279a
165a
280g
170c
281a
179d
282a
180e
283g
166a
292a
167a
297d
168g
299a
187c
301a
188g
303a
195e
304a
198a
308c
199a
310a
200a
317c
194a
319c
201e
321d
211e
334a
212e
313b
181a
312a
182a
324a
183a
325c
207b
327c
208d
329a
203a
331a
204a
337a
184g
316a
185a
344c
186a
346g
206c
338e
209b
348c
210d
350a
189g
332c
193a
365c
190a
352c
191a
354c
192g
340a
196d
342a
197c
357a
214b
359c
213d
361a
215g
368a
216g
362f
217a
364e
220a
381g
202a
385a
205c
386g
222a
383g
236f
389g
237a
376g
238g
379h
239a
374g
296a
391g
240g
370a
241g
371c
242a
373a
243a
307c
244d
305a
245a
309a
42a
311a
16e
318c
36e
320c
39f
322c
23f
335c
40a
314a
323a
45d
306a
41f
326c
221c
328f
250b
330f
270a
336c
271c
315a
249a
343a
252a
345c
253a
347a
254a
339g
263c
349c
272c
351a
255c
333c
256a
366c
273c
353a
257g
355a
258a
341c
259d
356c
260a
358c
261d
360c
262a
367g
264a
369g
265a
363a
266b
364d
275c
382a
284a
384g
285g
387a
286a
388a
287a
390a
288c
377a
289a
380a
290g
375a
291a
392a
295a
378c
298c
372a
300a
302a
26 . A pharmaceutical composition, comprising the compound of claim 1 , or a pharmaceutically acceptable salt thereof; and a pharmaceutically acceptable carrier.
27 . A method of treating e a disease or condition characterized by aberrant complement system activity, comprising administering to a subject in need thereof a therapeutically effective amount of a compound of claim 1 , or a pharmaceutically acceptable salt thereof;
wherein the disease or condition characterized by aberrant complement system activity is selected from the group consisting of paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, organ transplant rejection, myasthenia gravis, neuromyelitis optica, membranoproliferative glomerulonephritis, dense-deposit disease, cold agglutinin disease, catastrophic antiphospholipid syndrome, adult respiratory distress syndrome, myocardial infarct, lung inflammation, sepsis, cardiopulmonary bypass, burns, asthma, restenosis, multiple organ dysfunction, Guillain-Barré syndrome, hemorrhagic shock, glomerulonephritis, systemic lupus erythematosus, rheumatoid arthritis, infertility, Alzheimer's disease, multiple sclerosis, platelet storage, hemodialysis, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), warm autoimmune hemolytic anemia, IgA nephropathy, C3 glomerulonephritis, focal segmental glomerulosclerosis, macular degeneration, age-related macular degeneration (AMD), wet AMD, geographic atrophy, macular edema, diabetic macular edema, choroidal neovascularization (CNV), uveitis, Behcet's uveitis, proliferative diabetic retinopathy, non-proliferative diabetic retinopathy, glaucoma, hypertensive retinopathy, a corneal neovascularization disease, post-corneal transplant rejection, a corneal dystrophic disease, an autoimmune dry eye disease, Stevens-Johnson syndrome, Sjogren's syndrome, an environmental dry eye disease, Fuchs' endothelial dystrophy, retinal vein occlusion, post-operative inflammation, obesity, insulin resistance, diabetes, dyslipidemia, nephropathy, neuropathy, angioedema, hereditary angioedema or acquired angioedema, thrombotic microangiopathy, generalized myasthenia gravis, Parkinson's disease, schizophrenia, periodontitis, Crohn's disease, chronic obstructive pulmonary disease, acute respiratory distress syndrome, atherosclerosis, C3 glomerulopathy, membranous nephropathy, lupus nephritis, osteoarthritis, bullous pemphigoid, psoriasis, hidradenitis suppurativa, ischemia/reperfusion injury, acute kidney injury, organ transplantation, kidney transplant, systemic inflammatory response syndrome, septic shock, trauma, cancer, antibody-mediated rejection, antiphospholipid syndrome, Berger's disease, delayed graft function, granulomatosis with polyangiitis, graft versus host disease, hematopoietic stem cell transplant-related thrombotic microangiopathy, immune complex-mediated membranoproliferative glomerulonephritis, immune-mediated necrotizing myopathy, idiopathic polypoidal choroidal vasculopathy, microscopic polyangiitis, pyoderma gangrenosum, and Stargardt Disease 1.
28 . A compound represented by Formula (I-b), or a pharmaceutically acceptable salt thereof:
wherein, independently for each occurrence:
X is a bond or C(R X ) 2 ;
Y is a bond, C(R Y ) 2 , or —N(R b )—;
G is S or C(R 3 ) 2 ;
R a and R b are each independently H or (C 1 -C 6 )alkyl;
R 1 represents optionally substituted aryl or heteroaryl;
R 2 represents
R 3 is independently for each occurrence H, halogen, —CN, —NH 2 , —CH 2 NH 2 , (C 1 -C 6 )alkoxy or (C 1 -C 6 )alkyl; or two vicinal occurrences of R 3 taken together with the carbon atoms to which they are bonded form an optionally substituted fused (C 3 -C 7 )cycloalkyl or (C 6 )aryl; or two geminal occurrences of R 3 taken together with the carbon atom to which they are bonded form an optionally substituted spiro (C 3 -C 7 )cycloalkyl; or two hominal occurrences of R 3 taken together with the carbon atoms to which they are bonded form an optionally substituted bridged (C 3 -C 7 )cycloalkyl;
R X is independently for each occurrence H, (C 1 -C 6 )alkyl, or (C 3 -C 7 )cycloalkyl;
R Y is independently for each occurrence H, (C 1 -C 6 )alkyl, or (C 3 -C 7 )cycloalkyl;
optional substituents on R 1 each independently represent halogen, —CN, —NO 2 , —OR 13 , —NR 13 R 14 , —C(O)R 13 , —C(O)OR 13 , —C(O)NR 13 R 14 , —OC(O)R 13 , —NR 13 C(O)R 14 , —OC(O)NR 13 R 14 , —OC(O)OR 13 , —NR 13 C(O)OR 14 , —NR 13 C(O)NR 13 R 14 , —OS(O) p (R 13 ), —SR 13 , —NR 13 S(O) p (R 14 ), or optionally substituted alkyl, alkenyl, alkynyl, haloalkyl, hydroxyalkyl, alkoxyalkyl, cycloalkoxyalkyl, aryloxyalkyl, aralkyl, heteroaralkyl, heteroaryl, aryl, aryloxy, cycloalkyl, (cycloalkyl)alkyl, heterocycloalkyl, or (heterocycloalkyl)alkyl;
or wherein two substituents on R 1 , taken together with the intervening atoms, form a ring;
R 13 and R 14 , independently for each occurrence, represent H or optionally substituted alkyl, haloalkyl, alkenyl, alkynyl, aryl, or heteroaryl;
p is 0, 1, or 2;
Z 1 represents N or CR 1Z ;
Z 2 represents N or CR 2Z ;
Z 3 represents N or C;
Z 4 represents N;
Z 5 represents N or CR 5Z ;
Z 6 represents N;
Z 7 represents N or CR 7Z ;
Z 8 represents C;
Z 9 represents N or C;
R 7Z represents —NR 13 R 14 ;
m is an integer selected from 1-3; and
each occurrence of R 1Z , R 2Z , R 5Z , and R 2A independently represents H, halogen, —CN, —NO 2 , —OR 13 , —NR 13 R 14 , —C(O)R 13 , —C(O)OR 13 , —C(O)NR 13 R 14 , —OC(O)R 13 , —NR 13 C(O)R 14 , —OC(O)NR 13 R 14 , —OC(O)OR 13 , —NR 13 C(O)OR 14 , —NR 13 C(O)NR 13 R 14 , —OS(O) p (R 13 ), —SR 13 , —NR 13 S(O) p (R 14 ), or optionally substituted alkyl, alkenyl, alkynyl, haloalkyl, hydroxyalkyl, alkoxyalkyl, cycloalkoxyalkyl, aryloxyalkyl, aralkyl, heteroaralkyl, heteroaryl, aryl, aryloxy, cycloalkyl, (cycloalkyl)alkyl, heterocycloalkyl, or (heterocycloalkyl)alkyl; or
wherein an occurrence of R Y and an occurrence of R 2Z taken together with the intervening atoms form a ring.
29 . The compound of claim 28 , or a pharmaceutically acceptable salt thereof, selected from the following table:
#
Structure
75d
76b
158e
77b
78a
79a
81a
80a
82a
86b
87f
84a
90d
101b
91a
92b
93a
104a
105b
96e
107b
108b
109e
110d
123g
112b
118a
119a
117d
120c
116b
121d
115e
122c
68a
114f
67c
113a
65a
66b
64a
124b
130e
132d
133b
138d
134b
139b
135a
125d
136a
126f
137b
142d
140a
143d
141a
148d
146a
149b
5e
150d
152d
69a
153a
70a
2d
71a
154e
72a
73a
74a
233h
293a and 293b
30 . The compound of claim 28 , wherein Y represents C(R Y ) 2 .
31 . The compound of claim 28 , wherein Y represents CH 2 .
32 . The compound of claim 28 , wherein X represents a bond.
33 . The compound of claim 28 , wherein X represents CH 2 .
34 . The compound of claim 28 , wherein R 1 represents optionally substituted heteroaryl.
35 . The compound of claim 28 , wherein R 1 represents optionally substituted phenyl (e.g., 3-halophenyl, or 2,3-dihalophenyl), pyridinyl (e.g., 6-halopyridin-2-yl), or pyrazinyl (e.g., 6-halopyrazin-2-yl).
36 . The compound of claim 28 , wherein R 1 represents
37 . The compound of claim 28 , wherein R 1 represents
38 . The compound of claim 28 , wherein R 2 represents
39 . The compound of claim 28 , wherein R 2 represents
40 . The compound of claim 28 , wherein R 2 represents
41 . The compound of claim 28 , wherein R 2 represents
42 . The compound of claim 28 , wherein R 2 represents
43 . The compound of claim 42 , wherein R 2 represents
44 . The compound of claim 28 , wherein R 7Z represents —NH 2 .
45 . The compound of claim 28 , wherein R 5Z represents alkyl, halo, or —NR 13 R 14 .
46 . The compound of claim 28 , wherein R 1Z represents —CN, halo, haloalkyl, optionally substituted aryl, optionally substituted heteroaryl, optionally substituted alkyl, —SR 13 , —NR 13 R 14 , —OR 13 , or —NR 13 C(O)R 14 .
47 . The compound of claim 28 , wherein each occurrence of R 2A independently represents —CN, —NO 2 , halo, haloalkyl, optionally substituted aryl, optionally substituted heteroaryl, optionally substituted alkyl, optionally substituted alkenyl, optionally substituted hydroxyalkyl, —C(O)R 13 , —C(O)OR 13 , —NR 13 C(O)OR 14 , —SR 13 , —NR 13 R 14 , —OR 13 , —C(O)NR 13 R 14 , or —NR 13 C(O)R 14 .
48 . The compound of claim 28 , wherein G is C(R 3 ) 2 .
49 . The compound of claim 28 , having the structure of formula (Ia):
50 . The compound of claim 28 , wherein two vicinal occurrences of R 3 taken together with the carbon atoms to which they are bonded form an optionally substituted fused C 3 -cycloalkyl.
51 . The compound of claim 28 , wherein at least one occurrence of R 3 is halo.
52 . The compound of claim 28 , wherein at least one occurrence of R 3 is methyl.
53 . A pharmaceutical composition, comprising the compound of claim 28 , or a pharmaceutically acceptable salt thereof; and a pharmaceutically acceptable carrier.
54 . A method of treating a disease or condition characterized by aberrant complement system activity, comprising administering to a subject in need thereof a therapeutically effective amount of a compound of claim 28 , or a pharmaceutically acceptable salt thereof;
wherein the disease or condition characterized by aberrant complement system activity is selected from the group consisting of paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, organ transplant rejection, myasthenia gravis, neuromyelitis optica, membranoproliferative glomerulonephritis, dense-deposit disease, cold agglutinin disease, catastrophic antiphospholipid syndrome, adult respiratory distress syndrome, myocardial infarct, lung inflammation, sepsis, cardiopulmonary bypass, burns, asthma, restenosis, multiple organ dysfunction, Guillain-Barré syndrome, hemorrhagic shock, glomerulonephritis, systemic lupus erythematosus, rheumatoid arthritis, infertility, Alzheimer's disease, multiple sclerosis, platelet storage, hemodialysis, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), warm autoimmune hemolytic anemia, IgA nephropathy, C3 glomerulonephritis, focal segmental glomerulosclerosis, macular degeneration, age-related macular degeneration (AMD), wet AMD, geographic atrophy, macular edema, diabetic macular edema, choroidal neovascularization (CNV), uveitis, Behcet's uveitis, proliferative diabetic retinopathy, non-proliferative diabetic retinopathy, glaucoma, hypertensive retinopathy, a corneal neovascularization disease, post-corneal transplant rejection, a corneal dystrophic disease, an autoimmune dry eye disease, Stevens-Johnson syndrome, Sjogren's syndrome, an environmental dry eye disease, Fuchs' endothelial dystrophy, retinal vein occlusion, post-operative inflammation, obesity, insulin resistance, diabetes, dyslipidemia, nephropathy, neuropathy, angioedema, hereditary angioedema or acquired angioedema, thrombotic microangiopathy, generalized myasthenia gravis, Parkinson's disease, schizophrenia, periodontitis, Crohn's disease, chronic obstructive pulmonary disease, acute respiratory distress syndrome, atherosclerosis, C3 glomerulopathy, membranous nephropathy, lupus nephritis, osteoarthritis, bullous pemphigoid, psoriasis, hidradenitis suppurativa, ischemia/reperfusion injury, acute kidney injury, organ transplantation, kidney transplant, systemic inflammatory response syndrome, septic shock, trauma, cancer, antibody-mediated rejection, antiphospholipid syndrome, Berger's disease, delayed graft function, granulomatosis with polyangiitis, graft versus host disease, hematopoietic stem cell transplant-related thrombotic microangiopathy, immune complex-mediated membranoproliferative glomerulonephritis, immune-mediated necrotizing myopathy, idiopathic polypoidal choroidal vasculopathy, microscopic polyangiitis, pyoderma gangrenosum, and Stargardt Disease 1.
55 . A compound or a pharmaceutically acceptable salt thereof, selected from the following table:
#
Structure
157a
129f
156e
144g
88f
85b
89b
100b
102b
94b
103b
106b
95c
111b
97b
131e
98b
147a
99b
145a
235a
151a
127d
128a
155f
294c
83d
251f
56 . A pharmaceutical composition, comprising the compound of claim 55 , or a pharmaceutically acceptable salt thereof; and a pharmaceutically acceptable carrier.
57 . A method of treating a disease or condition characterized by aberrant complement system activity, comprising administering to a subject in need thereof a therapeutically effective amount of a compound of claim 55 , or a pharmaceutically acceptable salt thereof;
wherein the disease or condition characterized by aberrant complement system activity is selected from the group consisting of paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, organ transplant rejection, myasthenia gravis, neuromyelitis optica, membranoproliferative glomerulonephritis, dense-deposit disease, cold agglutinin disease, catastrophic antiphospholipid syndrome, adult respiratory distress syndrome, myocardial infarct, lung inflammation, sepsis, cardiopulmonary bypass, burns, asthma, restenosis, multiple organ dysfunction, Guillain-Barré syndrome, hemorrhagic shock, glomerulonephritis, systemic lupus erythematosus, rheumatoid arthritis, infertility, Alzheimer's disease, multiple sclerosis, platelet storage, hemodialysis, antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), warm autoimmune hemolytic anemia, IgA nephropathy, C3 glomerulonephritis, focal segmental glomerulosclerosis, macular degeneration, age-related macular degeneration (AMD), wet AMD, geographic atrophy, macular edema, diabetic macular edema, choroidal neovascularization (CNV), uveitis, Behcet's uveitis, proliferative diabetic retinopathy, non-proliferative diabetic retinopathy, glaucoma, hypertensive retinopathy, a corneal neovascularization disease, post-corneal transplant rejection, a corneal dystrophic disease, an autoimmune dry eye disease, Stevens-Johnson syndrome, Sjogren's syndrome, an environmental dry eye disease, Fuchs' endothelial dystrophy, retinal vein occlusion, post-operative inflammation, obesity, insulin resistance, diabetes, dyslipidemia, nephropathy, neuropathy, angioedema, hereditary angioedema or acquired angioedema, thrombotic microangiopathy, generalized myasthenia gravis, Parkinson's disease, schizophrenia, periodontitis, Crohn's disease, chronic obstructive pulmonary disease, acute respiratory distress syndrome, atherosclerosis, C3 glomerulopathy, membranous nephropathy, lupus nephritis, osteoarthritis, bullous pemphigoid, psoriasis, hidradenitis suppurativa, ischemia/reperfusion injury, acute kidney injury, organ transplantation, kidney transplant, systemic inflammatory response syndrome, septic shock, trauma, cancer, antibody-mediated rejection, antiphospholipid syndrome, Berger's disease, delayed graft function, granulomatosis with polyangiitis, graft versus host disease, hematopoietic stem cell transplant-related thrombotic microangiopathy, immune complex-mediated membranoproliferative glomerulonephritis, immune-mediated necrotizing myopathy, idiopathic polypoidal choroidal vasculopathy, microscopic polyangiitis, pyoderma gangrenosum, and Stargardt Disease 1.