Meningitis treatment clue

Scientists tested skin samples from children with meningococcal septicaemia

A discovery could counteract the effects of meningococcal septicaemia and may help doctors save lives and limbs.

The condition leads to severe blood clotting, visible in patients as a trademark rash, and causes gangrene.

Doctors have found that some patients with the disease are missing a key protein in the blood which prevents clots from forming, and treatment has often been to replace it.

But this study, published in the New England Journal of Medicine, shows two other proteins need to be there to kick-start the main protein.

Our study has identified a key mechanism involved in the devastating complications of meningococcal disease

Professor Michael Levin,
Imperial College

Trials have already begun on a drug which would do just that, and initial results in adults have proved successful.

Professor Michael Levin of Imperial College, London, who led 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."

Meningococcal septicaemia is the blood poisoning form of meningitis.

Within hours of the first symptoms being spotted, someone hit by meningococcal septicaemia can be fighting for their life.

Although advances in medicine have meant the numbers dying from the condition have fallen, many are left with long-term disability.

Protein defect

People who are healthy have proteins in their blood which prevent clots being formed in their veins and arteries.

One is called Protein C, and is key to preventing clots forming.

The study by doctors at Imperial College and St Mary's Hospital London, Bristol University, and in Oklahoma, America, studied skin samples of 21 children with severe meningococcal septicaemia.

They found they had also lost two key proteins - thrombomodulin and endothelial Protein C receptor - which the body has to have to activate Protein C on the blood vessels' wall.

Professor Levin said: "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."

Treatment

Trials of the Protein C activator drug are underway worldwide, including at St Mary's Hospital.

We are delighted with the outcome of this research which has the potential to prevent death and disability from meningitis and septicaemia

Denise Vaughan,
Meningitis Research Foundation

Dr Saul Faust, a medical research fellow at St Mary's and part of the research team, told BBC News Online the study was important because by taking skin biopsies, doctors had been able to study blood vessel walls for the first time.

"What we would be looking to see is whether activated Protein C can be safely used in children with meningococcal disease.

"If it was proved to be safe, it would hopefully stop some of the amputations, and stop children dying from meningococcal septicaemia."

Denise Vaughan, chief executive of the Meningitis Research Foundation, which funded the research, said: "We are delighted with the outcome of this research which has the potential to prevent death and disability from meningitis and septicaemia."