Researchers in the UK and the US report on the study in today's New England Journal of Medicine (NEJM).

The team from Imperial College and St. Mary's Hospital, London, in collaboration with research groups at the University of Bristol, UK, and Oklahoma, USA, say that their work offers new directions for treatment of the blood poisoning form of meningitis.

In healthy individuals, a number of proteins are present in the blood which act to prevent clots forming in veins and arteries. One of these is a recently identified protein called Protein C, which, when activated, is a powerful inhibitor of clot formation.

The NEJM study of 21 children establishes for the first time that patients suffering from meningococcal septicemia have lost two key proteins (thrombomodulin and endothelial Protein C receptor) required to activate Protein C on the lining of blood vessels.

This serious defect leads to an inability to control clotting within arteries and veins and opens the way to widespread clot formation, a hallmark of meningococcal septicemia, often visible as rashes on the skin.

To date, the development of effective treatments to prevent or reverse this clot formation has been hampered by a lack of understanding of the mechanisms involved.

Professor Michael Levin of Imperial College, leader of the study, said, "Our study has identified a key mechanism involved in the devastating complications of meningococcal disease, and offers new insights into how the disease might best be treated.

"A defect in the activation of Protein C could, theoretically, be treated by administration of Protein C in its active form, thus by-passing the requirements for activation on the surfaces of blood vessels."

Clinical trials are currently underway to assess the safety and feasibility of this treatment.

Denise Vaughan, Chief Executive of Meningitis Research Foundation, which funded the study, said, "We are delighted with the outcome of this research which has the potential to prevent death and disability from meningitis and septicemia."

The authors of the paper are Dr. Saul Faust, Professor Michael Levin, Odile Harrison, Dr. Robert Goldin and Dr. Sheila Kondaveeti (Imperial College and St Mary's Hospital, UK); Marion Lockhart (Oklahoma Medical Research Foundation, USA); Dr. Zoltan Lasik and Dr. Charles Esmon (University of Oklahoma Health Sciences Center, USA); and Dr. Robert Heyderman (University of Bristol, UK).

The program of research has been supported by a grant from the Meningitis Research Foundation with additional support via a training fellowship from the Medical Research Council.

Related website:

Imperial College

[Contact: Dr. Saul Faust, Tom Miller, Julia Warren]

09-Aug-2001