The parallel lives of alpha1-antitrypsin deficiency and pulmonary alveolar proteinosis

Abstract

In 1963, five cases of alpha1-antitrypsin deficiency were reported in the scientific literature, as well as an attempt to treat pulmonary alveolar proteinosis by a massive washing of the lung (whole lung lavage). Now, fifty years later, it seems the ideal moment not only to commemorate these publications, but also to point out the influence both papers had in the following decades and how knowledge on these two fascinating rare respiratory disorders progressed over the years. This paper is therefore not aimed at being a comprehensive review for both disorders, but rather at comparing the evolution of alpha1-antitrypsin, a rare disorder, with that of pulmonary alveolar proteinosis, an ultra-rare disease. We wanted to emphasize how all stakeholders might contribute to the dissemination of the awareness of rare diseases, that need to be chaperoned from the ghetto of neglected disorders to the dignity of recognizable and treatable disorders.

Figure 1

Carl-Bertil Laurell (Courtesy of eALTA Grifols).

Figure 2

José Ramirez Rivera with a young pulmonary staff member at University of Puerto Rico, 2012.

Figure 3

Milestones of the fifty years progress in the knowledge of AATD and PAP.