We were, however, puzzled by the observation that NE release by degranulation was so low in cases with GDM, when compared to normal pregnant controls (Figure 1E). As the EIA assay employed in this analysis detects a complex of NE with its native inhibitor A1AT, we examined the circulating concentrations of the latter, which indicated that these were significantly lower in GDM cases (Figure 1F). As this could lead to an incorrect measurement of NE levels, we accordingly assessed for NE enzymatic activity, which clearly indicated that elastase enzymatic activity was significantly higher in GDM cases than normal pregnant controls (Figure 1G).