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Review
. 2021 Feb 1;21(1):46-51.
doi: 10.1097/ACI.0000000000000711.

Alpha1-antitrypsin deficiency and asthma

Laura Pini  1   2 , Giovanni Paoletti  3   4 , Enrico Heffler  3   4 , Claudio Tantucci  1   2 , Francesca Puggioni  3   4 ; Asthma and Alpha1-Antitrypsin Research Group
Affiliations
Review

Alpha1-antitrypsin deficiency and asthma

Laura Pini et al. Curr Opin Allergy Clin Immunol. .

Abstract

Purpose of review: The aim of the article is to highlight the association between α1-antitrypsin deficiency (AATD) and asthma.

Recent findings: AATD is one of the most common and underrecognized autosomal disorders associated with an increased risk of developing liver and lung diseases. An association between α1-antitrypsin and asthma has been suggested, especially with severe forms of this disease. Many studies have shown an increased prevalence of asthma in the α1-antitrypsin-deficient population overtime (4-38%). The biological mechanism underlying these two conditions and able to bind them has not yet been well investigated. As α1-antitrypsin is the main inhibitor of the serine proteinase and it is an important anti-inflammatory protein with pronounced immunomodulatory activities, it can be hypothesized that the link between AATD and asthma might be represented by the elastase/antielastase imbalance and the proinflammatory effect that occurs because of the reduction of this protein.

Summary: There is a strong need for further researches to better understand the molecular mechanisms binding AATD and asthma. It is also recommendable to screen for AATD, late-onset asthma patients, and/or those with not fully reversible airways obstruction.

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MeSH terms