Alpha1-Antitrypsin Deficiency in COPD: Clinical Implications

, College of Physicians and Surgeons, Columbia University, NY

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Effect of Asthma on the Functional Activity of Alpha1-AT

Is there evidence that asthma is associated with an acquired functional deficit of alpha1-AT during airway inflammation?

Gaillard and colleagues[32] (Table II) reported that plasma alpha1-AT elastase inhibitory capacity and specific activity is reduced in asthmatics with a normal phenotype compared to those without asthma. Therefore, there is evidence for a functional reduction of alpha1-AT occurring in asthma. It is possible that this functional deficit perpetuates airway hyperreactivity through less than optimal control of inflammatory mediator release. In a later paper, Gaillard and colleagues[33] showed that inheritance of certain M (M1 ala 213) phenotypes are associated with a lower alpha1 elastase inhibitory capacity. The frequency of this allele is much higher in white asthmatics.

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