Plasminogen activator inhibitor-2 (placental PAI, SerpinB2, PAI-2), a serine protease inhibitor of the serpin superfamily, is a coagulation factor that inactivates tissue plasminogen activator and urokinase. It is present in most cells, especially monocytes/macrophages. PAI-2 exists in two forms, a 60-kDa extracellular glycosylated form and a 43-kDa intracellular form. It is present only at detectable quantities in blood during pregnancy, as it is produced by the placenta, and may explain partially the increased rate of thrombosis during pregnancy. The majority of expressed PAI-2 remains unsecreted due to the presence of an inefficient internal signal peptide. Interactions PAI-2 has been reported to bind a series of intracellular and extracellular proteins. Whether PAI-2's physiological function is inhibition of the extracellular protease urokinase and/or whether PAI-2 has intracellular activities remains controversial. At least one of PAI-2's physiological functions may involve regulation of adaptive immunity. Structure and polymerization Like other serpins, PAI-2 has three beta sheets (A, B, C) and nine alpha helices (hA-hI). The structure of PAI-2 mutants have been solved, in which the 33-amino acid loop connecting helices C and D is deleted. This CD-loop is particularly flexible and difficult to stabilize, as the loop is known to translocate up to 54 Å during the formation of intramolecular disulfide bonds. In addition to the CD-loop, notable motifs include the reactive center loop (RCL) spanning amino acids 379-383 and an N-terminal hydrophobic signal sequence. Despite their similar inhibitory targets, PAI-2 is phylogenetically distant from its counterpart plasminogen activator inhibitor-1 (PAI-1). As a member of the ovalbumin-related serpin family, PAI-2 is genetically similar to chicken ovalbumin (Gallus gallus), and is a close mammalian homolog. Both ovalbumin and PAI-2 undergo secretion via uncleaved secretory signal peptides, although PAI-2 secretion is relatively much less efficient. PAI-2 exists in three polymeric states: monomeric, polymerigenic, and polymer (inactive state). Polymerization occurs by a so-called "loop-sheet" mechanism, in which the RCL of one molecule sequentially inserts into the A-beta-sheet of the next molecule. This process occurs preferentially when PAI-2 is in its polymerigenic form, which is stabilized by a disulfide bond between Cys-79 (located in the CD-loop) and Cys-161. When PAI-2 is in its monomeric form, the CD-loop is vastly out-of-position for this disulfide linkage, and it must translocate a distance of 54 Å to become sufficiently close to Cys-161. Nevertheless, since the CD-loop is quite flexible, the monomeric and polymerigenic forms are fully interconvertible, and one state can