Alpha1-antitrypsin deficiency and asthma. Issue 1 (February 2021)

• Record Type: Journal Article
• Authors: Pini, Laura; Paoletti, Giovanni; Heffler, Enrico; Tantucci, Claudio; Puggioni, Francesca
• Is Part Of: Current opinion in allergy and clinical immunology. Volume 21:Issue 1(2021)
• Publication Date: 2021-02
• Subjects: α1-antitrypsin -- α1-antitrypsin deficiency -- α1-antitrypsin polymers -- asthma -- neutrophil asthma -- phenoendotyping asthma -- severe asthma; Allergy -- Periodicals; Clinical immunology -- Periodicals; Hypersensitivity; Immunity; Immune System Diseases; Allergy and Immunology; 616.079
• DOI: 10.1097/ACI.0000000000000711
• Languages: English
• ISSNs: 1528-4050

Abstract

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.