Alpha1-Antitrypsin Deficiency in COPD: Clinical Implications

, College of Physicians and Surgeons, Columbia University, NY

Disclosures
In This Article

Role of Asthma in Progression to Emphysema

The development of asthma in patients with alpha1-ATD may predispose to irreversible airway obstruction and emphysema. Both an elevated serum IgE and atopy, markers for asthma, have been associated with the development of COPD[35,36] and a more rapid deterioration of lung function in elderly normal subjects.[37,38]

Chronic asthma may lead to airway remodeling with thickening of the basement membrane and subepithelial fibrosis. Such changes may have an adverse impact on airway function in individuals with alpha1-ATD.[39] Furthermore, the effects of childhood asthma on lung growth, particularly in those with alpha1-ATD is unknown, but potentially significant.

Unpublished data from the NHLBI Registry of patients with alpha1-ATD show a significant -- approximately 20% -- increased rate of loss of FEV1 in those subjects ever showing a bronchodilator response. Therefore, the development of asthma in patients with alpha1-ATD may accelerate the development of chronic airway obstruction.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....