Diagnostiki Athinon no longer measures plasminogen activator inhibitor-1 (PAI-1).
Measuring plasminogen activator inhibitor-1 (PAI-1) helps diagnose certain genetic diseases with elevated or reduced levels, supports the differential diagnosis of fibrinolytic mechanism diseases, and serves as a prognostic factor for the occurrence or recurrence of thrombosis.
The plasminogen activator inhibitor-1 (PAI-1) is a member of a family of proteins that inhibit plasminogen activators. PAI-1 is a glycoprotein with a molecular weight of 47 kD. During fibrinolysis, tissue plasminogen activator (tPA) converts the inactive protein plasminogen to plasmin. Plasmin, in turn, plays a critical role in fibrinolysis by degrading fibrin. Plasmin also displays localized protease activity in several other physiological functions, including ovulation, cell migration, and epithelial cell differentiation.
The plasminogen activator inhibitor-1 is the major inhibitor of tPA and other plasminogen activators in the blood. PAI-1 limits plasmin production and helps control fibrinolysis. Uncontrolled production of plasmin can lead to excessive fibrin cleavage and an increased risk of bleeding. PAI-1 levels are partially gene-controlled. Certain polymorphisms in the PAI-1 gene are associated with increased blood concentrations. Elevated levels of PAI-1 have been shown to be associated with an increased risk of atherosclerotic lesions. Insulin and proinsulin levels also correlate with PAI-1 levels. Patients with insulin resistance syndrome and diabetes tend to have elevated PAI-1 levels. Weight loss and triglyceride and cholesterol-lowering treatment also reduce PAI-1 levels. PAI-1 has been shown to act as a prothrombotic factor in both arterial and venous thromboembolic disease. Elevated levels of PAI-1 are associated with an increased incidence of acute coronary syndrome, with chronic and acute coronary artery disease (CAD), and in patients suffering from restenosis after coronary angioplasty. It has also been shown that increased levels of PAI-1 may decrease the efficacy of antithrombotic therapy.
Plasminogen activator inhibitor-1 is an acute-phase protein and may transiently increase due to infection, inflammation, or trauma. PAI-1 levels increase during pregnancy.
