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Plasminogen activator inhibitor-1 levels and polymorphisms

Charles W Francis1

  • 1Vascular Medicine Unit, University of Rochester School of Medicine & Dentistry, Rochester, NY 14642, USA. charles_francis@urmc.rocheser.edu

Archives of Pathology & Laboratory Medicine
|November 8, 2002
PubMed

Insights

The link between plasminogen activator inhibitor-1 (PAI-1) levels or its 4G/5G gene variant and venous thromboembolism risk is unclear. Current evidence is conflicting, and PAI-1 testing is not recommended for thrombophilia evaluation.

Area of Science:

  • Biochemistry
  • Genetics
  • Hematology

Background:

  • Plasminogen activator inhibitor-1 (PAI-1) is a key regulator of the fibrinolytic system.
  • Elevated PAI-1 levels may theoretically increase thrombosis risk by inhibiting fibrinolysis.
  • The 4G/5G polymorphism in the PAI-1 gene promoter influences its expression levels.

Purpose of the Study:

  • To review existing literature on the association between PAI-1 and venous thromboembolic disease (VTE).
  • To evaluate the evidence linking PAI-1 plasma levels and the PAI-1 4G/5G polymorphism to VTE risk.

Main Methods:

  • Comprehensive review of published medical literature.
  • Utilized computerized databases and secondary sources for evidence identification.

Main Results:

  • Early studies suggested a link between PAI-1 levels and VTE, but were limited by methodological issues (e.g., circadian variation, acute phase response).
  • Studies on the PAI-1 4G/5G polymorphism have yielded inconsistent results regarding VTE risk.
  • Some research indicates higher PAI-1 plasma levels in individuals with the 4G/4G genotype.

Conclusions:

  • Conflicting evidence exists regarding the association between PAI-1 levels/genotype and VTE risk.
  • Insufficient data currently supports the routine use of PAI-1 levels or genotype for thrombophilia assessment.
Abstract

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