Current status and potential future of PAI-1 inhibitors

PAI-1 is an important factor in the fibrinolytic system. It is also involved in the etiopathogenesis of atherosclerotic processes, metabolic syndrome, obesity, and a significant number of solid and some of the hematological malignancies and even has valuable prognostic value. In this article, we review involvement of PAI-1 in areas other than the fibyrinolytic system, its roles, and its potential contribution to regulatory mechanisms and inhibition pathways. Many important studies proved that PAI-1 is significantly increased in obesity, metabolic syndrome, a significant proportion of malignancies. Although cell culture studies, in vivo studies and animal experiments have provided data on PAI-1 inhibition and models that block the pathways through which PAI-1 is metabolized and acts, suggesting that this blockade can reverse tumor progression, improve metabolic syndrome parameters and improve atherosclerotic processes, the results of these inhibitory agents in humans are still unknown and worth investigating. The upcoming phase 1-2 studies will answer these questions.