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Thread: PAI-1 4G/4G with normal PAI-1 levels

  1. #1
    Join Date
    Feb 2009
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    6

    Default PAI-1 4G/4G with normal PAI-1 levels

    Hi Dr. Coulam,

    Do you believe that a positive test for the the PAI-1 genetic mutation (i.e. homozygous 4G/4G) is of any concern in those cases where PAI-1 levels are not elevated, or is PAI-1 only a problem if the levels themselves are pathologically high?

    Also, has your research shown Lovenox or other anti-coagulants to be of any benefit for PAI-1 mutations?

    Thanks so much for your help

  2. #2
    Join Date
    Sep 2008
    Posts
    677

    Default

    It depends on the problem. PAI-1 4G/4G is more of a problem for implantation failure. If it is association with recurrent miscarriage, then lovenonx or heparin should help. Dr. Coulam

  3. #3
    Join Date
    Feb 2009
    Posts
    6

    Default

    Thank you, Dr. Coulam. So just to clarify, the PAI-1 4G/4G mutation has been associated with recurrent implantation failure even in those cases where PAI-1 levels are normal? Theoretically, what is the mechanism by which this would occur?

  4. #4
    Join Date
    Sep 2008
    Posts
    677

    Default

    Yes, PAI-1 inhibits PA which stimulates MMPS, the enzme nessary for the embryo to be able to invade in the lining of the uterus. Dr. Coulam

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