title: Protein misfolding and the serpinopathies.
abstract: The serpins are the largest superfamily of protease inhibitors. They are found in almost all branches of life including viruses, prokaryotes and eukaryotes. They inhibit their target protease by a unique mechanism that involves a large conformational transition and the translocation of the enzyme from the upper to the lower pole of the protein. This complex mechanism, and the involvement of serpins in important biological regulatory processes, makes them prone to mutation-related diseases. For example the polymerization of mutant alpha(1)-antitrypsin leads to the accumulation of ordered polymers within the endoplasmic reticulum of hepatocytes in association with cirrhosis. An identical process in the neuron specific serpin, neuroserpin, results in the accumulation of polymers in neurons and the dementia FENIB. In both cases there is a clear correlation between the molecular instability, the rate of polymer formation and the severity of disease. A similar process underlies the hepatic retention and plasma deficiency of antithrombin, C1 inhibitor, alpha(1)-antichymotrypsin and heparin co-factor II. The common mechanism of polymerization has allowed us to group these conditions together as a novel class of disease, the serpinopathies.
authors.affiliation: Department of Medicine, University of Cambridge, Cambridge Institute for Medical Research, Cambridge, United Kingdom.
authors.forename: Didier
authors.initials: D
authors.lastname: Belorgey
authors.forename: Peter
authors.initials: P
authors.lastname: Hägglöf
authors.forename: Susanna
authors.initials: S
authors.lastname: Karlsson-Li
authors.forename: David A
authors.initials: DA
authors.lastname: Lomas
mesh_terms: D000818:Animals; D003704:Dementia / Q000235:genetics / Q000378:metabolism; D005057:Eukaryotic Cells / Q000737:chemistry / Q000378:metabolism; D030342:Genetic Diseases, Inborn / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D008103:Liver Cirrhosis / Q000235:genetics / Q000378:metabolism; D009154:Mutation; D009928:Organ Specificity; D010447:Peptide Hydrolases / Q000737:chemistry / Q000235:genetics / Q000378:metabolism; D011387:Prokaryotic Cells / Q000737:chemistry / Q000378:metabolism; D011480:Protease Inhibitors / Q000737:chemistry / Q000378:metabolism*; D011487:Protein Conformation; D015843:Serpins / Q000737:chemistry / Q000235:genetics / Q000378:metabolism*; D014764:Viral Proteins / Q000737:chemistry / Q000235:genetics / Q000378:metabolism; D014780:Viruses / Q000737:chemistry / Q000235:genetics / Q000378:metabolism
chemical_list: D011480:Protease Inhibitors; D015843:Serpins; D014764:Viral Proteins; D010447:Peptide Hydrolases