SERPINA1 and carpal tunnel syndrome: Other genes encoding components of the extracellular matrix that were highlighted in the study include SERPINA1 and ITGB5. The missense variant (p.Glu366Lys) in SERPINA1 is the top signal in the meta-analysis and has a strong protective effect on CTS and also associates with the plasma levels of multiple proteins (Supplementary Data 6) supporting previously reported observations.