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M5 + C1-inhibitor is a combination thrombolytic therapy developed by TSI, LLC for the treatment of acute ischemic stroke. The combination consists of M5, a single-point mutant of the serine protease pro-urokinase (proUK), and C1-inhibitor, a serine protease inhibitor (serpin). M5 is engineered to be more stable than native pro-urokinase, reducing its conversion to non-specific urokinase at therapeutic concentrations. C1-inhibitor is included to further suppress the conversion of M5 to urokinase and to inhibit the complement and contact-kinin systems, which are involved in the inflammatory response following a stroke. This dual approach aims to provide a safer and more effective alternative to tissue plasminogen activator (tPA) by minimizing systemic bleeding risks and neuroinflammation.
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