An engineered complement receptor 1 composed of two functional domains can protect against immune-mediated hemolysis.

Complement receptor type 1 (CR1) is a versatile inhibitor of both classical and alternative pathway C3 and C5 convertases with an ability to accelerate decay activity and act as a co-factor in C3b/C4b cleavage. In order to develop a short form of CR1 with similar biological activities to the full-length human CR1, we combined functional domain 1, located in the long homologous repeat (LHR) A, with functional domain 2, located in LHR C. We expressed the two-domain, two-function protein with an enterokinase site at the N-terminus and a termination codon at the C-terminus in Escherichia coli. The fusion protein was purified on a Ni-NTA-agarose column. After subsequent refolding, the recombinant CR1-derivative protein was obtained by enterokinase cleavage and subsequent purification. In vitro, the recombinant CR1-derivative reduced hemolysis, C5a release and surface C3 deposition. It was also effective in prolonging survival of transfused incompatible red blood cells in vivo. Our results indicate that the CR1-based protein may be a model for developing smaller and more potent complement inhibitors for future therapeutics.