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rBbKI is a recombinant proteinase inhibitor derived from Bauhinia bauhinioides, a plant of the Bauhinia genus. It is a plant-derived serine protease inhibitor that potently inhibits enzymes such as human plasma kallikrein (HuPK), trypsin, plasmin, and chymotrypsin. Its mechanism involves reducing bradykinin release through inhibition of plasma kallikrein, which is implicated in inflammation and vascular permeability. In murine models, rBbKI has demonstrated the ability to reduce elastase-induced pulmonary inflammation, airway remodeling, and oxidative stress by decreasing inflammatory cell recruitment (notably TNF-α, MMP-9, MMP-12, TIMP-1, eNOS, iNOS). These actions translate into improvements in lung mechanics, attenuation of emphysema development, and reduction in markers of oxidative stress and extracellular matrix disruption. rBbKI also shows efficacy comparable to corticosteroids in models of asthma–COPD overlap (ACO). It has investigational applications in COPD, emphysema, asthma, and potentially cancer due to its effects on cell proliferation and angiogenesis.
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