Plasminogen activator inhibitor type 1 (PAI-1) is a serine protease inhibitor (serpin) in which the reactive center loop (RCL) spontaneously inserts into a central -sheet, -sheet A, resulting in inactive inhibitor. Available x-ray crystallographic studies of PAI-1 in an active conformation relied on the use of stabilizing mutations. Recently it has become evident that these structural models do not adequately explain the behavior of wild-type PAI-1 (wtPAI-1) in solution. To probe the structure of native wtPAI-1, we used three conformationally sensitive ligands: the physiologic cofactor, vitronectin; a monoclonal antibody, 33B8, that binds preferentially to RCL-inserted forms of PAI-1; and RCL-mimicking peptides that insert into -sheet A. From patterns of interaction with wtPAI-1 and the stable mutant, 14-1B, we propose a model of the native conformation of wtPAI-1 in which the bottom of the central sheet is closed, whereas the top of the -sheet A is open to allow partial insertion of the RCL. Because the incorporation of RCL-mimicking peptides into wtPAI-1 is accelerated by vitronectin, we further propose that vitronectin alters the conformation of the RCL to allow increased accessibility to -sheet A, yielding a structural hypothesis that is contradictory to the current structural model of PAI-1 in solution and its interaction with vitronectin.Serpins are a superfamily of proteins with a wide range of functions, such as inhibiting serine or cysteine proteases, serving as carrier molecules for hormones, and regulating the folding of other proteins (1). Despite primary sequence homologies as low as 25%, serpins share a highly conserved tertiary structure (1). The native fold of serpins is metastable and defines the mechanism of inhibition utilized by anti-proteolytic serpins.Serpins contain a solvent-exposed reactive center loop (RCL) 3 , which holds residues appropriate to the substrate specificity of cognate serine proteases (2-4). Attack by a protease on the P1-P1Ј bond of the serpin RCL is initiated via the conventional serine protease mechanism, yielding breakage of the peptide bond and a covalent acyl-enzyme intermediate in which the active site serine residue is ester-linked to the serpin P1 residue (5, 6). Breakage of the P1-P1Ј bond leads to a conformational change in the serpin, consisting of insertion of the RCL into -sheet A in the serpin core, translocation of the covalently attached protease a distance of 70 Å, and concomitant distortion the protease active site, which renders the protease incompetent to resolve the acyl-enzyme intermediate (7)(8)(9).Plasminogen activator inhibitor type-1 (PAI-1) is considered an archetypal serpin and is the most potent inhibitor of tissuetype and urokinase-type plasminogen activators (t-PA and u-PA, respectively) (10). PAI-1 is unlike most serpins in that it spontaneously inactivates under physiologic conditions with an in vitro half-life of 1-2 h (11). During this process, the RCL of PAI-1 inserts into -sheet A without prior proteolysis of the P1-P1Ј bond (1...