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Gelsolin is a multifunctional actin-binding protein that plays a central role in the regulation of actin filament assembly and disassembly. It exists in two main isoforms—cytoplasmic and plasma (secreted)—with the latter containing an additional N-terminal extension. Gelsolin severs and caps actin filaments in a calcium-dependent manner, thereby regulating cytoskeletal dynamics, cell motility, shape, metabolism, and apoptosis. Its activity is modulated by calcium ions (activation) and polyphosphoinositides such as PIP2 (inhibition). Beyond its structural roles, plasma gelsolin acts as an extracellular scavenger of actin released during tissue injury or disease and exhibits anti-inflammatory and immunomodulatory properties. Decreased levels are associated with critical illnesses like sepsis, ARDS, COVID-19-related cytokine storm/ALI/ARDS/MODS, myocardial infarction, liver failure, inflammation states and burns; increased levels are seen after rhabdomyolysis or in amyloidosis. Recombinant human plasma gelsolin has been investigated for therapeutic use to mitigate acute lung injury (ALI), ARDS—including severe COVID-19—and sepsis by scavenging extracellular actin filaments and modulating immune responses[1][4][5][6][7].
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