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α1-Antitrypsin (AAT) is one of the major proteins in the circulation eliciting significant protection against activated serine proteases, such as neutrophil elastase and proteinase-3. Moderate and severe AAT deficiency (AATD) is almost entirely caused by the Z (Glu342 to lysine change) and S (Glu264 to valine change) alleles as opposed to the normal wild-type M allele. Severe ZZ deficiency of AAT, characterised by a decrease in serum AAT levels to values <20% of normal, entails a high risk of developing pulmonary emphysema. This fact provides the rationale for the protease–antiprotease imbalance theory of the pathogenesis of emphysema.
We hypothesised that in subjects with AATD, other protease inhibitors may mitigate the …
Footnotes
Competing interests None.
Ethics approval This study was conducted with the approval of the Regional Ethical Review Board of Lund University, Sweden.
Provenance and peer review Not commissioned; externally peer reviewed.