The complex balance of the protease/anti-protease activity should, however, also take into account the fact that an excess of anti-protease activity, as described in the SERPINB3 variant SCCA-PD (NP_008850.1:p.Gly351Ala) [55,56] seen in 24% of the normal population, could alter cell homeostasis, leading in this case to an increased pro-fibrogenic profile and more severe liver portal hypertension in patients with cirrhosis (Martini et al. manuscript in preparation). Here, SERPINB3 is linked to medical procedure.