Like other serpin-enzyme complexes (SECs), proteinase-complexed C1 inhibitor (C1-INH) is rapidly cleared from the circulation and thought to be a neutrophil chemoattractant, suggesting that complex formation causes structural rearrangements exposing a domain which is recognized by specific cell surface receptors. However, the cellular receptor ( C1 inhibitor (C1-INH) 1 is the only known plasma inhibitor of C1 s and C1 r, the activated homologous serine proteases of the first component of complement (C1) (1). It is also one of the major inhibitors of plasma kallikrein and factor XIIa. Thus, C1-INH plays an essential role as a regulator of the activation of the classical complement pathway and the contact system, and genetic or acquired deficiencies of C1-INH result in recurrent episodes of angioedema (2). C1-INH is a member of the superfamily of serine proteinase inhibitors (serpins) and one of the most heavily glycosylated plasma proteins (3). Like other serpins, C1-INH inhibits target proteases by forming a stable covalent serpin-enzyme complex (SEC), resulting in the cleavage of the P1-P1Ј peptide bond of the reactive center loop of the inhibitor and in the generation of a COOH-terminal peptide of M r 4152 (4, 5). The formation of a SEC is accompanied with a large structural rearrangement of the serpin, and it has been concluded that this reveals a receptor recognition site (6). Thus, a crucial function of serpins is to provide a tag for the removal of proteolytic enzymes from the circulation by cellular receptors, thereby preventing excessive and harmful proteolysis of blood and tissue proteins (7). In general, SECs are cleared much more rapidly than are the proteolytically inactivated or native serpins (6). Although the data of Mast et al. (6) have indicated that the target protease does not play a role for the clearance of SECs, recent findings of de Smet et al. (8) and of Malek et al. (9) have shown that the clearance rates of different C1-INH-protease complexes significantly differ. They have found that the turnover was most rapid for C1-INH⅐C1 s, followed by C1-INH-kallikrein and C1-INH-XIIa, suggesting a direct role of the protease in determining the clearance receptor affinity. However, the receptor(s) involved in the catabolism of C1-INH-protease complexes has not been identified. Different types of receptors have been proposed for the binding and uptake of SECs. HepG2 cells, monocytes, and neutrophils have been reported to express a not yet completely characterized SEC receptor, which binds, internalizes, and degrades several serpin-protease complexes, including those with ␣ 1 -antitrypsin (␣ 1 -AT), ␣ 1 -antichymotrypsin (␣ 1 -ACT), antithrombin III (ATIII), and, to a much lesser extent, C1-INH⅐C1 s (10). Furthermore, the SEC receptor has been shown to mediate the