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Home arrow Environment arrow Inflammatory Disorders of the Nervous System: Pathogenesis, Immunology, and Clinical Management
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Inhibition of Complement (C) System

The C system is the core of innate immunity and is capable of inducing release of MP, especially in immune mediated disorders [153-155]. It can also degrade otherwise healthy cells expressing antibodies or damaged self-proteins and plays a major role in the clearance of many MP phenotypes. Accordingly, the C system may be a target of therapy in selected neurological disorders.

Fluitier et al., using a mouse model of traumatic brain injury (TBI) and an inhibitor of C6 made in their laboratory, were able to significantly promote neurological recovery and reduce secondary neuronal injury post-TBI by inhibiting the terminal membrane attack complex (MAC) [156]. At least three C inhibitors are approved for humans: compstatin [157, 158], the C1 inhibitor (C1-INH) [159], and eculi- zumab, approved for paroxysmal nocturnal hemoglobinuria (PNH) [160]. PNH can have neurological complications [161]. However, that the C system is also known to exert many effects favorable to tissue repair and recovery.

Pilzer et al. provide new insight on C-mediated MP generation, showing that a specific cellular protein, mortalin/GRP75, is responsible for shedding of MP with bound MAC, this being a mechanism for eliminating MAC from the cell surface [71, 155]. Sims et al. had earlier shown that cells can recover their membrane potentials after shedding MAC [153]. Mortalin is also known as the heat shock protein, HSPA9.

Elward et al. cast new light on C-mediated clearance of senescent cells and MP and underlying mechanisms which may in future allow manipulation of MP levels in blood or CSF. Their main finding was a key role for clustering of CD46, which then binds C1q or C opsonins [162]. (CD46 is also known as “membrane cofactor protein,” a C regulator, along with CD55 and CD59.)

 
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