Furthermore, hypoxia stress and elevated expression of hypoxia-inducible factor (HIF) due to hypoxemia in COPD can stimulate platelets to synthesize plasminogen activator inhibitor (PAI)-1, inducing a prothrombotic state associated with hypoxia (Chaurasia et al., 2019), which further promotes the development of COPD. The gene discussed is SERPINE1; the disease is chronic obstructive pulmonary disease.