Similarly, in the hemophilia A therapy (GS1191-0445) using the AAV8 vector, a modified frog Alb promoter (−66/+38, xAlb) was combined with elements from dog AAT (cAAT) and human AAT (hAAT), along with a synthetic enhancer (Figure 4G) [218]. This evidence concerns the gene SERPINA1 and hemophilia A.