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Anaphylotoxin inactivator deficiency(CPND)

MedGen UID:
98312
•Concept ID:
C0398782
•
Disease or Syndrome
Synonyms: Carboxypeptidase N deficiency; CPND; Deficiency of carboxypeptidase B
SNOMED CT: Deficiency of protaminase (124493003); Deficiency of carboxypeptidase B (124493003); Anaphylotoxin inactivator deficiency (234627009); Carboxypeptidase B deficiency (234627009); Carboxypeptidase N deficiency (234627009); Kininase I deficiency (234627009)
 
Gene (location): CPN1 (10q24.2)
 
Monarch Initiative: MONDO:0008910
OMIM®: 212070

Definition

Carboxypeptidase-N deficiency (CPND) is an autosomal recessive disorder characterized by episodic angioedema, acute or chronic urticaria, asthma, and/or allergic hypersensitivities such as hay fever. Homozygous individuals as well as their heterozygous family members have levels of carboxypeptidase N that are below the reference range, and heterozygotes are symptomatic, albeit to a generally milder degree (Mathews et al., 1980; Vincent et al., 2024). [from OMIM]

Clinical features

From HPO
Allergic rhinitis
MedGen UID:
382012
•Concept ID:
C2607914
•
Disease or Syndrome
It is characterized by one or more symptoms including sneezing, itching, nasal congestion, and rhinorrhea.
See: Feature record | Search on this feature
Decreased circulating carboxypeptidase N activity
MedGen UID:
1054007
•Concept ID:
CN377392
•
Finding
Activity of the enzyme Carboxypeptidase N (arginine carboxypeptidase, EC 3.4.17.3) in the blood circulation below the lower limit of normal.
See: Feature record | Search on this feature
Angioedema
MedGen UID:
1543
•Concept ID:
C0002994
•
Pathologic Function
Rapid swelling (edema) of the dermis, subcutaneous tissue, mucosa and submucosal tissues of the skin of the face, normally around the mouth, and the mucosa of the mouth and/or throat, as well as the tongue during a period of minutes to several hours. The swelling can also occur elsewhere, typically in the hands. Angioedema is similar to urticaria, but the swelling is subcutaneous rather than on the epidermis.
See: Feature record | Search on this feature
Urticaria
MedGen UID:
22587
•Concept ID:
C0042109
•
Disease or Syndrome
Raised, well-circumscribed areas of erythema and edema involving the dermis and epidermis. Urticaria is intensely pruritic, and blanches completely with pressure.
See: Feature record | Search on this feature
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Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAnaphylotoxin inactivator deficiency

Professional guidelines

PubMed

C1-Esterase inhibitor: an anti-inflammatory agent and its potential use in the treatment of diseases other than hereditary angioedema.
Caliezi C, Wuillemin WA, Zeerleder S, Redondo M, Eisele B, Hack CE
Pharmacol Rev 2000 Mar;52(1):91-112. PMID: 10699156

Recent clinical studies

Etiology

Thrombin-activatable fibrinolysis inhibitor influences disease severity in humans and mice with pneumococcal meningitis.
Mook-Kanamori BB, Valls Serón M, Geldhoff M, Havik SR, van der Ende A, Baas F, van der Poll T, Meijers JC, P Morgan B, Brouwer MC, van de Beek D
J Thromb Haemost 2015 Nov;13(11):2076-86. Epub 2015 Oct 1 doi: 10.1111/jth.13132. PMID: 26340319
Variants in Complement Factor H and Complement Factor H-Related Protein Genes, CFHR3 and CFHR1, Affect Complement Activation in IgA Nephropathy.
Zhu L, Zhai YL, Wang FM, Hou P, Lv JC, Xu DM, Shi SF, Liu LJ, Yu F, Zhao MH, Novak J, Gharavi AG, Zhang H
J Am Soc Nephrol 2015 May;26(5):1195-204. Epub 2014 Sep 9 doi: 10.1681/ASN.2014010096. PMID: 25205734Free PMC Article
An imbalance of human complement regulatory proteins CFHR1, CFHR3 and factor H influences risk for age-related macular degeneration (AMD).
Fritsche LG, Lauer N, Hartmann A, Stippa S, Keilhauer CN, Oppermann M, Pandey MK, Köhl J, Zipfel PF, Weber BH, Skerka C
Hum Mol Genet 2010 Dec 1;19(23):4694-704. Epub 2010 Sep 15 doi: 10.1093/hmg/ddq399. PMID: 20843825
Into the third century of complement research.
Morgan BP, Daha M, Meri S, Nicholson-Weller A
Immunol Today 2000 Dec;21(12):603-5. doi: 10.1016/s0167-5699(00)01742-4. PMID: 11188795
Plasma protease inhibitor and anaphylatoxin inactivator levels in chronic urticaria/angioedema and in patients experiencing anaphylactoid reactions to radiographic contrast media.
Mathews KP, Pan PM, Amendola MA, Lewis FH
Int Arch Allergy Appl Immunol 1986;79(2):220-3. doi: 10.1159/000233975. PMID: 3943918

Diagnosis

Human Complement C4B Allotypes and Deficiencies in Selected Cases With Autoimmune Diseases.
Zhou D, Rudnicki M, Chua GT, Lawrance SK, Zhou B, Drew JL, Barbar-Smiley F, Armstrong TK, Hilt ME, Birmingham DJ, Passler W, Auletta JJ, Bowden SA, Hoffman RP, Wu YL, Jarjour WN, Mok CC, Ardoin SP, Lau YL, Yu CY
Front Immunol 2021;12:739430. Epub 2021 Oct 26 doi: 10.3389/fimmu.2021.739430. PMID: 34764957Free PMC Article
Controlling the complement system in inflammation.
Kirschfink M
Immunopharmacology 1997 Dec;38(1-2):51-62. doi: 10.1016/s0162-3109(97)00057-x. PMID: 9476114
Trypanosoma lewisi: restriction of alternative complement pathway C3/C5 convertase activity.
Sturtevant JE, Balber AE
Exp Parasitol 1987 Jun;63(3):260-71. doi: 10.1016/0014-4894(87)90172-x. PMID: 3556206
The role of complement in urticaria and angioedema.
Gelfand JA
Clin Immunol Rev 1981-1982;1(2):257-309. PMID: 6762276

Therapy

The Role of Complement C3a Receptor in Stroke.
Ahmad S, Bhatia K, Kindelin A, Ducruet AF
Neuromolecular Med 2019 Dec;21(4):467-473. Epub 2019 May 17 doi: 10.1007/s12017-019-08545-7. PMID: 31102134
Paroxysmal nocturnal haemoglobinuria.
Hill A, DeZern AE, Kinoshita T, Brodsky RA
Nat Rev Dis Primers 2017 May 18;3:17028. doi: 10.1038/nrdp.2017.28. PMID: 28516949Free PMC Article
Complement and periodontitis.
Hajishengallis G
Biochem Pharmacol 2010 Dec 15;80(12):1992-2001. Epub 2010 Jun 23 doi: 10.1016/j.bcp.2010.06.017. PMID: 20599785Free PMC Article
Into the third century of complement research.
Morgan BP, Daha M, Meri S, Nicholson-Weller A
Immunol Today 2000 Dec;21(12):603-5. doi: 10.1016/s0167-5699(00)01742-4. PMID: 11188795
Beta2 integrins are required for neutrophil degranulation induced by hemodialysis membranes.
Cheung AK, Parker CJ, Hohnholt M
Kidney Int 1993 Mar;43(3):649-60. doi: 10.1038/ki.1993.94. PMID: 8455364

Prognosis

C1-inhibitor substitution therapy in septic shock and in the vascular leak syndrome induced by high doses of interleukin-2.
Hack CE, Ogilvie AC, Eisele B, Eerenberg AJ, Wagstaff J, Thijs LG
Intensive Care Med 1993;19 Suppl 1:S19-28. doi: 10.1007/BF01738946. PMID: 8053997
Role of complements C3 and C5 in the phagocytosis of liposomes by human neutrophils.
Scieszka JF, Maggiora LL, Wright SD, Cho MJ
Pharm Res 1991 Jan;8(1):65-9. doi: 10.1023/a:1015830306839. PMID: 1826557

Clinical prediction guides

Complement and periodontitis.
Hajishengallis G
Biochem Pharmacol 2010 Dec 15;80(12):1992-2001. Epub 2010 Jun 23 doi: 10.1016/j.bcp.2010.06.017. PMID: 20599785Free PMC Article
C1-Esterase inhibitor: an anti-inflammatory agent and its potential use in the treatment of diseases other than hereditary angioedema.
Caliezi C, Wuillemin WA, Zeerleder S, Redondo M, Eisele B, Hack CE
Pharmacol Rev 2000 Mar;52(1):91-112. PMID: 10699156
Beta2 integrins are required for neutrophil degranulation induced by hemodialysis membranes.
Cheung AK, Parker CJ, Hohnholt M
Kidney Int 1993 Mar;43(3):649-60. doi: 10.1038/ki.1993.94. PMID: 8455364
Role of complements C3 and C5 in the phagocytosis of liposomes by human neutrophils.
Scieszka JF, Maggiora LL, Wright SD, Cho MJ
Pharm Res 1991 Jan;8(1):65-9. doi: 10.1023/a:1015830306839. PMID: 1826557
Generation of chemotactic activity in serum by Haemophilus influenzae type b.
Tosi MF, Kaplan SL, Mason EO, Buffone GJ, Anderson DC
Infect Immun 1984 Feb;43(2):593-9. doi: 10.1128/iai.43.2.593-599.1984. PMID: 6607218Free PMC Article

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