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SERPING1
SERPING1 Full Name
serpin peptidase inhibitor, clade G (C1 inhibitor), member 1
SERPING1 Introduction
Researchers and clinicians studying inflammatory diseases often face a major challenge: understanding why some patients develop severe swelling, uncontrolled complement activation, or chronic tissue inflammation despite standard treatment approaches. SERPING1 (serpin family G member 1), also known as C1 inhibitor (C1-INH), has emerged as a critical regulatory molecule at the center of these processes. The SERPING1 gene encodes a plasma serine protease inhibitor that tightly controls the complement cascade, kallikrein-kinin system (KKS), coagulation, and fibrinolytic pathways. By inhibiting proteases such as C1r, C1s, plasma kallikrein, and factor XIIa, SERPING1 helps maintain vascular integrity and immune homeostasis. Dysfunction of this pathway can trigger excessive bradykinin production, increased vascular permeability, and uncontrolled inflammation, making SERPING1 highly relevant in immunology, rare disease research, and precision medicine. Recent genomic studies have identified hundreds of pathogenic SERPING1 variants, including missense mutations, splice-site alterations, large deletions, and de novo mutations, many of which directly impair C1-INH secretion, stability, or inhibitory activity.

The biological importance of SERPING1 is most clearly demonstrated in hereditary angioedema (HAE), a potentially life-threatening disorder characterized by recurrent episodes of swelling affecting the skin, gastrointestinal tract, and upper airway. In many HAE patients, SERPING1 mutations lead to either reduced levels of functional C1 inhibitor or production of structurally abnormal protein with impaired activity. Genotype-phenotype studies have shown that different mutation classes can influence disease severity, attack frequency, and treatment response, although incomplete penetrance remains a major clinical challenge. Beyond hereditary angioedema, growing evidence suggests that SERPING1 also plays a broader anti-inflammatory and tissue-protective role in chronic diseases. Multiomics analyses and Mendelian randomization studies have linked higher circulating SERPING1 levels with reduced risk of chronic obstructive pulmonary disease (COPD), supporting its role as an endogenous regulator of inflammatory lung injury. Researchers are increasingly interested in how SERPING1 balances complement activation and bradykinin signaling in pulmonary inflammation, vascular leakage, and immune-mediated tissue damage.
Emerging cancer biology studies have further expanded interest in SERPING1 as a therapeutic and prognostic target. Recent evidence in lung adenocarcinoma (LUAD) demonstrates that SERPING1 expression is significantly downregulated in tumor tissues compared with normal lung tissue, suggesting a tumor-suppressive role in the lung microenvironment. Mechanistically, SERPING1 appears to suppress tumor progression through regulation of the TSC2/mTOR signaling pathway, while upstream transcriptional control by the WNT-associated factor SP5 may explain altered expression patterns during tumorigenesis. Low SERPING1 expression has also been associated with poorer patient survival and altered responses to immunotherapy, highlighting its potential value as a predictive biomarker. These findings are driving increasing interest in SERPING1-targeted therapeutics, including plasma-derived and recombinant C1 inhibitors, which are already clinically effective in HAE and are now being explored for broader applications in inflammatory disease, pulmonary disorders, complement-mediated pathology, and cancer immunomodulation.
Alternate Names for SERPING1
SERPING1; serpin peptidase inhibitor, clade G (C1 inhibitor), member 1; C1IN; C1NH; HAE1; HAE2; C1INH; plasma protease C1 inhibitor; serpin G1; C1-inhibiting factor; C1 esterase inhibitor; complement component 1 inhibitor; serine/cysteine proteinase inhibitor clade G member 1;
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