Key Found to Controlling Clotting in Meningitis

A study has shown the way to control clotting within the arteries and veins of patients with meningococcal septicemia, the blood poisoning form of meningitis. Conducted by U.K. and U.S. researchers, the study was published in the August 9, 2001, issue of the New England Journal of Medicine.

The development of effective treatments to prevent or reverse clot formation has been hampered by a lack of understanding of the mechanisms involved. The study demonstrated for the first time that patients suffering from meningococcal septicemia have lost two key proteins required to activate protein C on the lining of blood vessels: thrombomodulin and endothelial protein C receptor. When activated, protein C is a powerful inhibitor of clotting. Lacking the two proteins results in the inability to control clotting within arteries and veins, leading to widespread clot formation and to death or the loss of limbs and digits. This finding suggests a new approach to treatment.

"A defect in the activation of protein C could, theoretically, be treated by administration of protein C in its active form, thereby bypassing the requirements for activation on the surface of blood vessels,” noted Prof. Michael Levin of Imperial College (London, UK), the leader of the study. Clinical trials are currently in progress to assess the safety and feasibility of this treatment.