That impaired fibrinolysis is an important factor in the pathophysiology of human sepsis is supported by the finding that a 4G/5G polymorphism in the PAI-1 promoter, leading to high PAI-1 expression, was associated with poor outcome in meningococcal sepsis11,33 and with multiple organ dysfunction and shock in pneumonia-induced severe sepsis.113. The gene discussed is SERPINE1; the disease is pneumonia.