[1] PAPPA is a secreted protease whose main substrate is insulin-like growth factor binding proteins.
[2][3] PAPPA encodes a secreted metalloproteinase which cleaves insulin-like growth factor binding proteins (IGFBPs).
It is thought to be involved in local proliferative processes such as wound healing and bone remodeling.
[2] Low levels may alternatively predict issues with the placenta, resulting in adverse complications such as intrauterine growth restriction, preeclampsia, placental abruption, premature birth, or fetal death.
Concentrations of the Pregnancy-Associated Plasma Protein (PAPPA) gene as well as other markers can help screen for Down's syndrome in the beginning stages of a women's gestational period.