Pathway / Fibrous-cap degradation & rupture

Alpha-1 Antitrypsin

SERPINA1protein

Alpha-1 antitrypsin inhibits neutrophil elastase and matrix metalloproteinases, protecting fibrous-cap integrity in atherosclerotic plaques.

Pathway placement

Cascade stepFibrous-cap degradation & rupture

Confidencemedium

RationaleProtease inhibitor preventing elastase-driven extracellular-matrix degradation.

Also acts inVascular inflammation

Druggability

DruggableYes

Known drugs / candidates0

Small-molecule tractableYes

Antibody tractableYes

EnsemblENSG00000197249

Type I vs non-Type I discrimination

ScoresNon-Type-I-associated

R — rupture / Type-I

—

C — non-Type-I

A — assay feasibility

E — evidence strength

T1DI (composite)

Specificity differential (R−C)-40.6

Non-Type-I axis panel

Does this marker also move in each non-Type-I setting? mag 0–3; higher means less Type-I-specific. n/a = no evidence retrieved, which is not the same as no change.

2sepsis / systemic inflammationn/a

2anemia / acute blood lossn/a

2hypovolemia / dehydrationn/a

2tachyarrhythmian/a

2hypoxemia / respiratory failuremag 2

2hypertensive emergencyn/a

2high-demand / peri-operative stressn/a

3sudden cardiac deathmag 1

4aPCI-related periproceduraln/a

4bstent thrombosisn/a

4cin-stent restenosisn/a

5CABG-relatedmag 2

Coverage: 3/12 axes with evidence

Tier: deep-scored (abstract-extracted) · 9 supporting references. See the discrimination table for all markers.

Assay & specimen

Class-level default (no specific cleared assay)— generic method inferred from analyte class; confirm against a specific product insert before use.

Specimen

Serum or plasma

Collection tube

Serum separator (gold/red-top, SST) · K2/K3-EDTA (lavender-top)

Method / principle

Sandwich immunoassay (ELISA) — research-grade unless a cleared assay exists

Reagent / substrate

Matched anti-target antibody pair (capture + labeled detection)

Platform

ELISA microplate or multiplex (Luminex/MSD)

Turnaround · availability

Send-out / research · Research-grade (no universal clinical assay)

Literature evidence(1)

Proteomic analysis of plasma from patients during an acute coronary syndrome.
Journal of the American College of Cardiology · 2004 · PMID 15489088 · doi