PAI-1 and associated pathways could serve as specific diagnostic markers for peripartum cardiomyopathy, but therapeutic reduction of PAI-1 may be harmful due to its protective role against cardiac fibrosis.
PAI-1 merits evaluation as PPCM biomarker; leaves open net benefit of therapeutic modulation given dual roles.
In PPCM patients, circulating and cardiac PAI-1 expression are up-regulated. While circulating PAI-1 may add 16 kDa-PRL to induce vascular impairment via the uPAR/NF-κB/miR-146a pathway, experimental data suggest that cardiac PAI-1 expression seems to protect the PPCM heart from fibrosis. Thus, measuring circulating PAI-1 and miR-146a, together with an uPAR/NF-κB-activity assay could be developed into a specific diagnostic marker assay for PPCM, but unrestricted reduction of PAI-1 for therapy may not be advised.
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Ricke‐Hoch et al. (2019) studied this question.
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