C5 convertase is an enzyme belonging to a family of serine proteases that play key role in the innate immunity. It participates in the complement system ending with cell death.Cell-bound C3 and C5 convertase differ in their C3b requirement. C3-convertase (C3bBb) need only one molecule of C3b to form, whereas two or more C3b are required for generation of C5 convertase (C3bBb). It means, when C3b is randomly distributed on the surface of a cell, only C3 convertase activity appears after addition of Factors B and D. However, when C3b is distributed in clusters, C3 and C5 convertase activity is generated upon addition of Factors B and D.The target of C5 convertase is complement protein C5. C5 is a two-chain (α, β) plasma glycoprotein (Mr = 196,000). C5 and C3 have similar structure. However, C5 does not appear to contain the internal thiol ester group reported for C3 and C4. C5 has relatively few disulfide bonds. There are three disulfide bonds in C5a, the α-chain has 15 half-Cystines, and the β-chain has only 6 half-Cystines. This comparatively low level of stabilizing disulfide bridges may provide a partial explanation for the irreversible conformational change imparted on C5 after cleavage to C5a and C5b. In addition, the relatively low number of disulfide bonds could account for instability of C5 when exposed to chaotropic agents such as potassium thiocyanate. Electron micrographs of negatively stained C5 indicate that the protein is irregular in shape and contains several lobes.Both enzymes, C4b2b3b and C3bBbC3b, are unstable and undergo decay dissociation with a half-life at 37 °C of approximately 1.5 - 3 min. The properdin stabilizes the alternative pathway C5 convertase of which half-life is at 37 °C 10 - 34 min. In contrast, the fluid phase C5 convertase CVFBb is stable (half-life at 37 °C = 7 h). The oxidation of C2 protein stabilizes the C4b2boxy complex.The Factor H–related protein 1 (CFHR1) has been identified as a novel inhibitor of the complement pathway. CFHR1 blocks C5 convertase activity and interferes with C5b surface deposition and membrane attack complex (MAC) formation. Apparently Factor H and CFHR1 control complement activation in a sequential manner. In hemolytic uremic syndrome (HUS), the absence of CFHR1 may result in reduced inhibition of terminal complex formation and in reduced protection of endothelial cells upon complement attack.