Upregulated Act A has been shown in many catabolic disease states, including ovarian cancer, endometrial adenocarcinoma, prostate, multiple myeloma, esophageal, breast and pancreatic cancers, and noncancer settings, such as chronic renal failure, heart failure, and pulmonary hypertension 33. The gene discussed is SERPINA3; the disease is pulmonary arterial hypertension.