SERPINA3 and diabetic kidney disease: Serine protease inhibitor A family member 3 (SERPINA3) acts primarily as a protease inhibitor and plays an important role in the regulation of cellular processes such as oxidative stress, fibrosis, angiogenesis, inflammatory response and apoptosis (46, 47) In diabetic nephropathy, immune-related SERPINA3 inhibits mast cell proliferation and activation by downregulating chymase activity, thereby alleviating disease progression (48).