Alpha1-Antitrypsin Deficiency in COPD: Clinical Implications

, College of Physicians and Surgeons, Columbia University, NY

In This Article


Table I - Factors Affecting the Protease/Antiprotease Balance

  • Abnormalities of alpha1-antitrypsin phenotype

  • Proteolytic inactivation by matrix metalloproteinase

  • Cytokine release due to acute/chronic bronchial inflammation

  • Activated neutrophil elastase excess

  • Increased oxidation of alpha1-antitrypsin (ie, cigarette smoke)

  • Binding of alpha1-antitrypsin by bacterial products (ie, Pseudomonas in cystic fibrosis)

Table II - Functional Deficiency of Alpha1-Antitrypsin in Asthma: Phenotype and Biochemical Characteristics

  n Plasma level (g/L) EIC (Ku/L) *SA (Ku/g)
No asthma (M1M1) 24 1.92 42.4 22.1
Asthma 22 2.07 36.8 17.7
* P<0.02

EIC=elastase inhibitory capacity; SA=specific activity

Reprinted with permission from Gaillard MC, Kilroe-Smith TA, Nogheira C, et al: Alpha1 protease inhibitor in bronchial asthma: Phenotypes and biochemical characteristics. Am Rev Respir Dis 145:1311-1313, 1992. Official Journal of the American Thoracic Society (c)American Lung Association.


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