Journal article : Review
A serpin with a finger in many PAI’s: PAI-1’s central function in thromboinflammation and cardiovascular disease
- Abstract:
- Plasminogen activator inhibitor 1 (PAI-1) is a member of the serine protease inhibitor (serpin) superfamily. PAI-1 is the principal inhibitor of the plasminogen activators, tissue plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA). Turbulence in the levels of PAI-1 tilts the balance of the haemostatic system resulting in bleeding or thrombotic complications. Not surprisingly there is strong evidence that documents the role of PAI-1 in cardiovascular disease. The more recent uncovering of the coalition between the haemostatic and inflammatory pathways have exposed a distinct role for PAI-1. The storm of proinflammatory cytokines liberated during inflammation, including IL-6 and TNFα, directly influence PAI-1 synthesis and increase circulating levels of this serpin. Consequently, elevated levels of PAI-1 are commonplace during infection and are frequently associated with a hypofibrinolytic state and thrombotic complications. Elevated PAI-1 levels are also a feature of metabolic syndrome, which is defined by a cluster of abnormalities including obesity, type 2 diabetes, hypertension and elevated triglyceride. Metabolic syndrome is in itself defined as a proinflammatory state associated with elevated levels of cytokines. In addition, insulin has a direct impact on PAI-1 synthesis bridging these pathways. This review describes the key physiological functions of PAI-1 and how these become perturbed during disease processes. We focus on the direct relationship between PAI-1 and inflammation and the repercussion in terms of an ensuing hypofibrinolytic state and thromboembolic complications. Collectively these observations strengthen the utility of PAI-1 as a viable drug target for treatment of various diseases.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 1.0MB, Terms of use)
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- Publisher copy:
- 10.3389/fcvm.2021.653655
Authors
- Publisher:
- Frontiers Media
- Journal:
- Frontiers in Cardiovascular Medicine More from this journal
- Volume:
- 8
- Article number:
- 653655
- Publication date:
- 2021-04-16
- Acceptance date:
- 2021-02-23
- DOI:
- ISSN:
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2297-055X
- Language:
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English
- Keywords:
- Subtype:
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Review
- Pubs id:
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1167909
- Local pid:
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pubs:1167909
- Deposit date:
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2021-03-15
Terms of use
- Copyright holder:
- Morrow et al.
- Copyright date:
- 2021
- Rights statement:
- Copyright © 2021 Morrow, Whyte and Mutch. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
- Licence:
- CC Attribution (CC BY)
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