SerpinC1, also known as the gene encoding antithrombin III (ATIII), is a serine protease inhibitor. ATIII has anticoagulant and anti-inflammatory actions. It is a key coagulation factor inhibitor, with even minor changes in ATIII significantly altering the risk of thromboembolism. ATIII can suppress inflammation via coagulation-dependent or-independent effects and is involved in multiple physiological and pathological processes [1].

SerpinC1 has been associated with various diseases. In kidney-related diseases, ATIII encoded by SerpinC1 affects the progress of kidney disease, though further studies are needed on its impact on renal function and treatment [1]. In colon cancer, SerpinC1 promotes cancer progression through epithelial-mesenchymal transition (EMT), is related to TNM stage and prognosis, and reduces the sensitivity to immune checkpoint therapy [2]. Congenital or acquired SerpinC1 deficiencies are risk factors for thromboembolic disease, and oral contraceptive use can lead to acquired SerpinC1 deficiency [3]. In lupus nephritis, urine SerpinC1 may be a biomarker for early detection [4]. Mutations in SerpinC1 are associated with antithrombin deficiency, and the SerpinC1 gene test is useful in determining the cause of AT-deficiency-related arterial thrombosis, especially ischemic stroke [5,6]. In preeclampsia, lower SerpinC1 levels in early-onset preeclampsia may be related to the disease, and it could be a potential early-diagnosis marker [7].

In conclusion, SerpinC1, through encoding ATIII, plays crucial roles in anticoagulation, anti-inflammation, and is involved in multiple disease processes such as kidney diseases, colon cancer, thromboembolic diseases, lupus nephritis, and preeclampsia. Understanding SerpinC1's functions and its associated mutations through various studies helps in revealing disease mechanisms and may potentially lead to new diagnostic and therapeutic strategies.