The acquired deficiency of C1-inhibitor: lymphoproliferation and angioedema

Curr Mol Med. 2010 Jun;10(4):354-60. doi: 10.2174/156652410791317066.

Abstract

Acquired deficiency of C1 inhibitor (C1-INH) with angioedema symptoms (acquired angioedema, AAE) is characterized by local increase in vascular permeability (angioedema) of the skin and the gastrointestinal and oro-pharyngo-laryngeal mucosa. The mediator of symptoms is bradykinin, a potent vasoactive peptide, released from high molecular weight kininogen when it is cleaved by plasma kallikrein a serine protease controlled by C1-INH. Autoantibodies inactivating C1-INH are detected in the majority of patients and account for the deficiency. Irrespectively to the presence of anti-C1-INH autoantibodies lymphoproliferative diseases, ranging from benign monoclonal gammopathies to malignant lymphoma, are frequently associated with AAE. Demonstration that monoclonal components correspond to anti-C1-INH autoantibodies and correlation between course of lymphoma and course of AAE provide strong support to consider the two diseases expression of the same pathologic process.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angioedema / blood
  • Angioedema / etiology*
  • Angioedema / immunology
  • Autoantibodies / blood
  • B-Lymphocytes / immunology
  • Bradykinin / physiology
  • Capillary Permeability
  • Complement C1 Inhibitor Protein / immunology
  • Complement C1 Inhibitor Protein / metabolism*
  • Female
  • Humans
  • Lymphoproliferative Disorders / blood
  • Lymphoproliferative Disorders / etiology*
  • Lymphoproliferative Disorders / immunology
  • Male
  • Models, Biological

Substances

  • Autoantibodies
  • Complement C1 Inhibitor Protein
  • Bradykinin