The CD59 gene, located on chromosome 11p13, encodes a glycosylphosphatidylinositol (GPI)-anchored cell surface glycoprotein that serves as a pivotal regulator of the complement system. CD59, also known as MAC-inhibitory protein (MAC-IP) or protectin, functions by binding to the C8 and C9 components of the nascent membrane attack complex (MAC), thereby inhibiting its final assembly and pore formation on host cell membranes. This activity is essential for protecting "self" cells from unintended complement-mediated lysis, a process critical for maintaining tissue homeostasis and preventing autologous damage.
The role of CD59 extends beyond basic immune regulation. Its expression on a wide variety of cells, including erythrocytes, endothelial cells, and immune cells, highlights its systemic importance in complement restriction. Dysregulation or deficiency of CD59 is implicated in several pathological conditions. For instance, in paroxysmal nocturnal hemoglobinuria (PNH), a acquired deficiency of GPI-anchored proteins like CD59 on blood cells leads to chronic complement-mediated hemolysis. Furthermore, many cancer types, such as glioblastoma and colorectal carcinoma, frequently overexpress CD59 as a key mechanism of complement evasion, contributing to tumor survival, progression, and resistance to antibody-based therapies. Consequently, CD59 has emerged as a significant therapeutic target, with strategies ranging from blocking antibodies to CAR-T cells designed to overcome this immunosuppressive barrier in the tumor microenvironment.