Protein C Replacement in Severe Meningococcemia: Rationale and Clinical Experience

Alberio, Lorenzo; Lämmle, Bernhard; Esmon, Charles T. (2001). Protein C Replacement in Severe Meningococcemia: Rationale and Clinical Experience. Clinical infectious diseases, 32(9), pp. 1338-1346. The University of Chicago Press 10.1086/319995

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Severe meningococcemia, which is associated with hemodynamic instability, purpura fulminans and disseminated intravascular coagulation, still has a high mortality rate, and patients who survive are often left invalids because of amputations and organ failure. Clinical studies have shown that levels of protein C are markedly decreased in patients with severe meningococcemia and that the extent of the decrease correlates with a negative clinical outcome. There is a growing body of data demonstrating that activated protein C, in addition to being an anticoagulant, is also a physiologically relevant modulator of the inflammatory response. The dual function of protein C may be relevant to the treatment of individuals with severe meningococcal sepsis. In the present review we give a basic overview of the protein C pathway and its anticoagulant activity, and we summarize experimental data showing that activated protein C replacement therapy clearly reduces the mortality rate for fulminant meningococcemia.

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