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Review

C1-inhibitor: an anti-inflammatory reagent with therapeutic potential

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Pages 1073-1083 | Published online: 24 Feb 2005

Bibliography

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  • ••Experimental study in dogs showing thatCl-inhibitor markedly reduced cardio-pulmonary dysfunction in endotoxic shock highlighting Cl-inhibitor as a potential therapeutic candidate in sepsis.
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  • ••In a model of E coil septicemia inprimates, Cl-inhibitor markedly reduced activation of the classical complement pathway and the factor XII contact activation as well as synthesis of several cytokines, whereas the haemodynamic changes were not prevented.
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  • ••Excellent study, suggesting a role for Cl-inhibitor in septicemia in the absence of a functional complement system.
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  • MARX G, NASHAN B, COBAS MM et al.: Septic shock after liver transplantation for Caroli's disease: clinical improvement after treatment with Cl-esterase inhibitor. Intensive Care Med. (1999) 25:1017–1020.
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  • ARZNEIMITTELKOMMISSION DER DEUTSCHEN ARZTESCHAFT: Schwerwiegende Thrombenbildung nach Berinert S. Deutsches Arzteblatt (2000) 97:A1015
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  • WUILLEMIN WA, TE VH, LUBBERS YT, DE RUIG CP, ELDERING E, HACK CE: Potentiation of Cl inhibitor by glycosaminoglycans: dextran sulfate species are effective inhibitors of in vitro complement activation in plasma. Immuriol (1997) 159:1953–1960.
  • •Interesting in vitro study, showing the potentiating effect of Cl-inhibitor on the classical complement pathway and suggesting its potential value for therapeutic complement inhibition.
  • KIRSCHFINK M, KOVACS B, MOTTAGHY K: Extracorporeal Circulation - in vivo and in vitro analysis of complement activation by heparin-bonded surfaces. Circ. Shock (1993) 40:221–226.
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  • RADKE A, MOTTAGHY K, GOLDMANN C et al.: Cl inhibitor prevents capillary leakage after thermal trauma. Grit. Care Med. (2000) 28:3224–3232.
  • JOSTKLEIGREWE F, BRANDT KA, JANSSEN AC: Cl-esterase inhibitor (C1-INH) as adjuvant therapy for septic shock following severe thermal trauma. Ann. Haematol. (1997) 74(Suppl.):A159.
  • BUERKE M, MUROHARA T, LEFER AM: Cardioprotective effects of a Cl esterase inhibitor in myocardial ischemia and reperfusion. Circulation (1995) 91:393–402.
  • ••In an experimental feline model ofmyocardial ischaemia, evidence is provided that Cl-inhibitor is a possible therapeutic candidate in myocardial infarction.
  • HORSTICK G, HEIMANN A, GOTZE O et al.: Intracoronary application of Cl esterase inhibitor improves cardiac function and reduces myocardial necrosis in an experimental model of ischemia and reperfusion. Circulation (1997) 95:701–708.
  • BUERKE M, PRUFER D, DAHM M, OELERT H, MEYER J, DARIUS H: Blocking of classical complement pathway inhibits endothelial adhesion molecule expression and preserves ischemic myocardium from reperfusion injury. Pharmacol Esp. Ther. (1998) 286:429–438.
  • MINNEMA MC, PETERS RJ, DE WINTER R et al.: Activation of clotting factors XI and IX in patients with acute myocardial infarction. Arterioscler. Thromb. Vasc. Biol. (2000) 20:2489–2493.
  • BAUERNSCHMITT R, BOHRER H, HAGL S: Rescue therapy with Cl-esterase inhibitor concentrate after emergency coronary surgery for failed PTCA. Intensive Care Med. (1998) 24:635–638.
  • DE ZWAAN, KLEINE A, DIRIS J et al: Complement inhibition and myocardial protection in patients with acute myocardial infarction. j Am. Coll. Cardiol (2001) 35(Suppl. A): 312. Abstract.
  • LEHMANN TG, HEGER M, MUNCH S, KIRSCHFINK M, KLAR E: In vivo microscopy reveals that complement inhibition by Cl-esterase inhibitor reduces ischemiaireperfusion injury in the liver. Transpl. Int. (2000) 13\(Suppl. 1):5547–S550.
  • HEIMANN A, TAKESHIMA T, HORSTICK G, KEMPSKI O: Cl-esterase inhibitor reduces infarct volume after cortical vein occlusion. Brain Res. (1999) 838:210–213.
  • BALDWIN WM, SAMANIEGOPICOTA M, KASPER EK et al.: Complement deposition in early cardiac transplant biopsies is associated with ischemic injury and subsequent rejection episodes. Transplantation (1999) 68:894–900.
  • PLATT JL, SAADI S: The role of complement in transplantation. Mal Immune]. (1999) 36:965–971.
  • •Review on the role of complement in allo-and xenotransplantation
  • SALVATIERRA A, VELASCO F, RODRIGUEZ M et al: C 1 -esterase inhibitor prevents early pulmonary dysfunction after lung transplantation in the dog. Am. J. Respir: Grit. Care Med. (1997) 155:1147–1154.
  • KLIMA U, KUTSCHKA I, WARNECKE G et al.: Improved right ventricular function after intracoronary administration of a Cl esterase inhibitor in a right heart transplantation model. Eur. j Cardiatharac. &mg. (2000) 18:321–327.
  • HENTJES B, JANKOWSKI M, VANGEROW B et al: C I -esterase-inhibitor levels in patients with and without reperfusion injury following lung transplantation (LTx). Ann. Haematal (1997) 74(Suppl.):A157.
  • STROBER M, HAGL C, HIRT SW, CREMER J, HARRINGER W HAVERICH A: Cl-esterase inhibitor in graft failure after lung transplantation. Intensive Care Med. (1999) 25:1315–1318.
  • •Although case-reports only, the results point to a possible role for Cl-inhibitor to prevent lung transplant rejection.
  • SAADI S, PLATT JL: Role of complement in xenotransplantation. OM. Exp. Pharmacal Physial (1999) 26:1016–1019.
  • DALMASSO AP PLATT JL: Prevention of complement-mediated activation of xenogeneic endothelial cells in an in vitro model of xenograft hyperacute rejection by Cl inhibitor. Transplantation (1993) 56:1171–1176.
  • HECKL-OSTREICHER B, WOSNIK A, KIRSCHFINK M: Protection of porcine endothelial cells from complement-mediated cytotoxicity by the human complement regulators CD59, Cl inhibitor, and soluble complement receptor type 1. Analysis in a pig-to-human in vitro model relevant to hyperacute xenograft rejection. Transplantation (1996) 62:1693–1696.
  • •One of the few reports where the protective effect of several complement inhibitors can be compared in the same experimental design.
  • DI STEFANO R, FROSINI SCAVUZZO M et al.: Cl-Inh and heparan sulfate can prevent discordant rejection. Transplant Proc. (1994) 26:1172–1173.
  • FIANE AE, VIDEM V, JOHANSEN HT, MELLBYE OJ, NIELSEN EW, MOLLNES TE: Cl-inhibitor attenuates hyperacute rejection and inhibits complement, leukocyte and platelet activation in an ex vivo pig-to-human perfusion model. Immurropharmacology (1999) 42:231–243.
  • SOLVIK UO, HARALDSEN G, FIANE AE, BORETTI E, THORSBY E, MOLLNES TE: Cl-inhibitor attenuates human serum induced E-selectin expression of pig aortic endothelial cells. Transplant. Proc. (2001) 33:789–790.
  • MATSUNAMI K, MIYAGAWA S, YAMADA M, YOSHITATSU M, SHIRAKURA R: A surface-bound form of human Cl esterase inhibitor improves xenograft rejection. Transplantation (2000) 69:749–755.
  • ••A construct of human full-length Cl-inhibitor and a transmembrarte anchor provides a novel approach for protection of hyperacute xenotransplant rejection.
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