A Review of Alpha-1 Antitrypsin Deficiency

Ioachimescu, Octavian C.; Stoller, James K.

doi:10.1081/copd-200057602

Cited by 2 publications

(2 citation statements)

References 49 publications

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“…The study of these proteinases has been complicated by the diversity of COPD phenotypes, which include components of emphysema and chronic bronchitis, as well as the common co-morbid cardiovascular and other systemic diseases associated with COPD, all of which potentially confound the analyses of biomarker-disease associations [1,5]. Because AATD-associated emphysema represents a more homogenous phenotype of COPD, with a more rapid decline in pulmonary status, generally at a younger age with fewer comorbidities, it offers a potential model for understanding COPD pathogenesis with respect to proteinases beyond those directly inhibited by alpha 1 -antitrypsin [2,6]. …”

Section: Introductionmentioning

confidence: 99%

Matrix metalloproteinase-9 predicts pulmonary status declines in α1-antitrypsin deficiency

Omachi

Eisner²,

Rames

et al. 2011

Respir Res

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BackgroundMatrix metalloproteinase-9 (MMP-9) may be important in the progression of emphysema, but there have been few longitudinal clinical studies of MMP-9 including pulmonary status and COPD exacerbation outcomes.MethodsWe utilized data from the placebo arm (n = 126) of a clinical trial of patients with alpha1-antitrypsin deficiency (AATD) and emphysema to examine the links between plasma MMP-9 levels, pulmonary status, and COPD exacerbations over a one year observation period. Pulmonary function, computed tomography lung density, incremental shuttle walk test (ISWT), and COPD exacerbations were assessed at regular intervals over 12 months. Prospective analyses used generalized estimating equations to incorporate repeated longitudinal measurements of MMP-9 and all endpoints, controlling for age, gender, race-ethnicity, leukocyte count, and tobacco history. A secondary analysis also incorporated highly-sensitive C-reactive protein levels in predictive models.ResultsAt baseline, higher plasma MMP-9 levels were cross-sectionally associated with lower FEV1 (p = 0.03), FVC (p < 0.001), carbon monoxide transfer factor (p = 0.03), resting oxygen saturation (p = 0.02), and ISWT distance walked (p = 0.02) but were not associated with radiographic lung density or total lung capacity (TLC). In longitudinal analyses, MMP-9 predicted a further decline in transfer factor (p = 0.04) and oxygen saturation (p < 0.001). MMP-9 also predicted worsening lung density (p = 0.003), increasing TLC (p = 0.02), and more frequent COPD exacerbations over follow-up (p = 0.003). Controlling additionally for hs-CRP levels did not substantively change the longitudinal associations between MMP-9 and these outcomes.ConclusionsIncreased plasma MMP-9 levels generally predicted pulmonary status declines, including worsening transfer factor and lung density as well as greater COPD exacerbations in AATD-associated emphysema.

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Section: Introductionmentioning

confidence: 99%

Matrix metalloproteinase-9 predicts pulmonary status declines in α1-antitrypsin deficiency

Omachi

Eisner²,

Rames

et al. 2011

Respir Res

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“… 23 , 27 – 29 Currently, although alpha-1-antitrypsin deficiency is the only robustly defined inherited form of COPD that can explain familial aggregation of COPD, 30 <3% of people with COPD have this deficiency. 31 Intergenerational associations overlap with the risk factors associated with the development of COPD, including smoking behavior of parents and offspring, educational achievement, lung function, and conditions or diseases such as asthma and lung cancer. 29 , 32 – 35 Concepts, knowledge, and behaviors about health can be transmitted from one generation to the next.…”

Section: Introductionmentioning

confidence: 99%

“What are my chances of developing COPD if one of my parents has the disease?” A systematic review and meta-analysis of prevalence of co-occurrence of COPD diagnosis in parents and offspring

Li¹,

Paquet²,

Johnston³

et al. 2017

COPD

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IntroductionIntergenerational associations in chronic obstructive pulmonary disease (COPD) have been well recognized and may result from genetic, gene environment, or exposure to life course factors. Consequently, adult offspring of parents with COPD may be at a greater risk of developing COPD. The aim of this study was to review the prevalence of co-occurrence of COPD in adult offspring with one or both parents having COPD independent of specific genetic variations.MethodsIn total, five databases were searched for original studies in which prevalence of COPD was reported in both offspring (children) and one or both parents. Studies were excluded if COPD was not clearly defined, COPD was linked to specific genetic variations, COPD was combined with other chronic respiratory conditions, or estimates included other first-degree relatives. Data extraction (ie, sample characteristics, prevalence of COPD, and odds ratio [OR] if reported) was completed by two independent reviewers. A meta-analysis of prevalence and OR was conducted, where possible.ResultsOf the 3,382 citations, 129 full texts were reviewed to include eight studies (six case–control, one cross-sectional, and one cohort) reflecting either prevalence of COPD in offspring of parents with COPD (descendent approach, n=3), which ranged from 0% to 17.3%, or prevalence of people with COPD reporting positive parental history of COPD (antecedent approach, n=5), for which the pooled prevalence was 28.6%. Offspring of people with COPD had 1.57 times greater odds (95% confidence interval =1.29–1.93; P<0.001) of having COPD compared with people not having a parental history of COPD.ConclusionThe prevalence of COPD in adult offspring of people with COPD is greater than population-based estimates, and the ORs indicate a higher risk in this group. This offers clinicians a potential strategy for opportunistic screening, early identification, and intervention in this at-risk group.

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A Review of Alpha-1 Antitrypsin Deficiency

Cited by 2 publications

References 49 publications

Matrix metalloproteinase-9 predicts pulmonary status declines in α1-antitrypsin deficiency

Matrix metalloproteinase-9 predicts pulmonary status declines in α1-antitrypsin deficiency

“What are my chances of developing COPD if one of my parents has the disease?” A systematic review and meta-analysis of prevalence of co-occurrence of COPD diagnosis in parents and offspring

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A Review of Alpha-1 Antitrypsin Deficiency

Cited by 2 publications

References 49 publications

Matrix metalloproteinase-9 predicts pulmonary status declines in α1-antitrypsin deficiency

Matrix metalloproteinase-9 predicts pulmonary status declines in α1-antitrypsin deficiency

&ldquo;What are my chances of developing COPD if one of my parents has the disease?&rdquo; A systematic review and meta-analysis of prevalence of co-occurrence of COPD diagnosis in parents and offspring

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“What are my chances of developing COPD if one of my parents has the disease?” A systematic review and meta-analysis of prevalence of co-occurrence of COPD diagnosis in parents and offspring