Alpha1-antitrypsin deficiency and asthma

Purpose of review The aim of the article is to highlight the association between a1-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 a1-antitrypsin and asthma has been suggested, especially with severe forms of this disease. Many studies have shown an increased prevalence of asthma in the a1-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 a1-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.