The Effects of Inflammation on Alpha 1 Antitrypsin Levels in a National Screening Cohort

ABSTRACTAlpha 1 Antitrypsin (AAT) is a highly polymorphic serum protein. Several genetic variants are associated with varying degrees of decreased serum levels; however, these levels can rise in response to infection, inflammation, injury and estrogen levels. Although the effect of inflammation is well established, it has never been studied quantitatively with respect to specific genotypes in a large representative sample. Using data from a national AAT deficiency-targeted screening cohort, we evaluated AAT levels of patients with normal and deficiency genotypes in response to inflammation, indicated by elevated serum C-reactive protein (CRP). Additionally, we utilized a regression analysis to adjust for the effect of inflammation for each genotype. Across all stratified genotype groups, increased AAT levels were observed in patients with CRP ≥5 mg/L. Different AAT phenotypes reacted differently in the acute phase; M showed a strong response and Z a reduced reaction. Nevertheless, we discovered that infla...