Complement, a target for therapy in inflammatory and degenerative diseases
B Paul Morgan1, Claire L Harris1,2
1Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK.
Insights
The complement system, crucial for immunity, can cause harm when overactivated. This review explores anti-complement therapies targeting diseases driven by complement dysregulation.
Area of Science:
- Immunology
- Pharmacology
Background:
- The complement system is a vital part of innate immunity, defending against pathogens.
- However, uncontrolled complement activation can lead to inflammation, tissue damage, and various diseases.
Purpose of the Study:
- To review the history, current status, and future prospects of anti-complement therapies.
- To highlight the complement system as a target for drug development.
Main Methods:
- Review of existing literature on complement biology and anti-complement drugs.
- Analysis of the complement cascade, its components, and regulatory mechanisms.
- Examination of therapeutic strategies targeting complement.
Main Results:
- The complement system offers multiple drug development targets due to its complex cascade, proteases, and receptors.
- Currently, only two anti-complement drugs are approved, but numerous others are in development.
- Therapies are being developed for infectious, inflammatory, degenerative, traumatic, and neoplastic disorders.
Conclusions:
- The complement system's dual role in defense and disease makes it a significant therapeutic target.
- Advancements in structural biology facilitate the design of novel anti-complement drugs.
- The field of anti-complement therapy is rapidly expanding with promising future directions.
Abstract:
The complement system is a key innate immune defence against infection and an important driver of inflammation; however, these very properties can also cause harm. Inappropriate or uncontrolled activation of complement can cause local and/or systemic inflammation, tissue damage and disease. Complement provides numerous options for drug development as it is a proteolytic cascade that involves nine specific proteases, unique multimolecular activation and lytic complexes, an arsenal of natural inhibitors, and numerous receptors that bind to activation fragments. Drug design is facilitated by the increasingly detailed structural understanding of the molecules involved in the complement system. Only two anti-complement drugs are currently on the market, but many more are being developed for diseases that include infectious, inflammatory, degenerative, traumatic and neoplastic disorders. In this Review, we describe the history, current landscape and future directions for anti-complement therapies.
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