SERPINE1 and Shock: Furthermore, a 4G/5G insertion/deletion polymorphism in the SERPINE1 promoter region was found to determine plasma PAI-1 levels and promotes severe coagulopathy, with high levels of PAI-1 associated with severe meningococcal septic shock and poor outcome of IMD (Table 2) (Binder et al. 2007a; Geishofer et al. 2005; Hermans et al. 1999; Westendorp et al. 1999).