Effect Of Alpha-1 Antitrypsin Research Articles

Effect of alpha-1 antitrypsin and alpha-1-acid glycoprotein levels on prognosis in patients with COPD exacerbation and COPD-community-acquired pneumonia

Aims: Chronic obstructive pulmonary disease (COPD) is the most frequent comorbid condition that is present in patients with pneumonia. An exacerbations of chronic obstructive pulmonary disease (ECOPD) and Comminity-acquired pneumonia (CAP) are associated with high rates of hospitalizations, costs, and morbidity. Plasma levels of orosomucoid and Alpha-1 antitrypsin (AAT), also known as Alpha-1-acid glycoprotein (AGP), increase in response to inflammation and tissue necrosis. The purpose of this study is to evaluate the impact of markers in patients with ECOPD and COPD with pneumonia . Methods: To compare the levels of AAT, and AGP, between patients diagnosed with ECOPD only and patients diagnosed with COPD and pneumonia. Results: The study included 14 female and 22 male volunteers. The mean gender and age of groups 1 and 2 were similar. There was no statistical difference in laboratory values between the groups. Conclusion: Alpha-1-acid glycoprotein and AAT are acute-phase proteins elevated in various inflammatory conditions such as infections, trauma, and chronic diseases such as COPD. More studies are needed on their usefulness for monitoring and/or treatment in daily practice.

Alpha-1 antitrypsin supplementation improves alveolar macrophages efferocytosis and phagocytosis following cigarette smoke exposure.

Cigarette smoking (CS), the main risk factor for COPD (chronic obstructive pulmonary disease) in developed countries, decreases alveolar macrophages (AM) clearance of both apoptotic cells and bacterial pathogens. This global deficit of AM engulfment may explain why active smokers have worse outcomes of COPD exacerbations, episodes characterized by airway infection and inflammation that carry high morbidity and healthcare cost. When administered as intravenous supplementation, the acute phase-reactant alpha-1 antitrypsin (A1AT) reduces the severity of COPD exacerbations in A1AT deficient (AATD) individuals and of bacterial pneumonia in murine models, but the effect of A1AT on AM scavenging functions has not been reported. Apoptotic cell clearance (efferocytosis) was measured in human AM isolated from patients with COPD, in primary rat AM or differentiated monocytes exposed to CS ex vivo, and in AM recovered from mice exposed to CS. A1AT (100 μg/mL, 16 h) significantly ameliorated efferocytosis (by ~50%) in AM of active smokers or AM exposed ex vivo to CS. A1AT significantly improved AM global engulfment, including phagocytosis, even when cells were simultaneously challenged with apoptotic and Fc-coated (bacteria-like) targets. The improved efferocytosis in A1AT-treated macrophages was associated with inhibition of tumor necrosis factor-α converting enzyme (TACE) activity, decreased mannose receptor shedding, and markedly increased abundance of efferocytosis receptors (mannose- and phosphatidyl serine receptors and the scavenger receptor B2) on AM plasma membrane. Directed airway A1AT treatment (via inhalation of a nebulized solution) restored in situ airway AM efferocytosis after CS exposure in mice. The amelioration of CS-exposed AM global engulfment may render A1AT as a potential therapy for COPD exacerbations.

Association of elevated alpha-1 antitrypsin with advanced clinicopathologic features of hepatocellular carcinoma.

289 Background: Alpha-1 Antitrypsin (A1AT) is a circulating liver derived protease inhibitor. There is an evolving evidence that elevated level of A1AT stimulate tumor cell proliferation, and invasion in different cancers. Despite A1AT well-known involvement in hepatic fibrosis, its role in hepatocellular carcinoma (HCC) pathogenesis is not well characterized. The current study aimed to investigate the association between A1AT and clinicopathologic features and prognosis of patients with HCC. Methods: Between 2001 and 2014, total of 766 HCC patients from MD Anderson Cancer Center were enrolled. Under IRB approval, baseline patients’ clinical characteristics were retrieved from medical records. The normal level of plasma A1AT was defined based on the Mayo clinic reference value (1 – 1.9 mg/ml). Survival analysis included Kaplan Meier statistic and Cox regression analysis. Multivariate Hazard Ratio (HR) and 95% Confidence interval (CI) were estimated to determine the independent effect of A1AT on HCC prognosis. Results: The mean and standard deviation of plasma A1AT level was 2.7 ± 0.98 mg/mL. All patients were categorized into 2 groups: group 1 (N = 156) with normal serum level ( ≤ 1.9) and group 2 (N = 610) with higher values ( > 1.9). Median survival (months), 95% CI were 24.4 (18.02 – 30.7) and 11.6 (9.6 – 13.6) in group 1 and 2 respectively, (P < .0001). Patients in group 2 experienced poor clinical characteristics than group 1. The estimated multivariate HR (95% CI) for A1AT is 1.4 (1.1 – 1.7) after adjustment for age, sex, race, cirrhosis, AFP, TNM staging, and treatment exposure. Conclusions: High plasma level of A1AT is associated with higher α-feto protein, advanced TNM and Barcelona clinic liver cancer (BCLC) staging and poor survival of HCC patients. Recent preliminary studies suggested that changes in glycosylaion of production of A1AT by HCC cells correlates with the microenvironment inflammatory and proteolytic activities, which are probably linked to advanced clinicopathologic features and poorer survival. Future excremental studies are warranted to understand the mechanistic pathways of potential A1AT involvement in HCC initiation and progression.

Different forms of alpha-1 antitrypsin and neutrophil activation mediated by human anti-PR3 IgG antibodies.

One of characteristic findings in granulomatosis with polyangiitis (GPA) is the presence of proteinase-3 (anti-PR3) specific antibodies. These antibodies can cause neutrophil activation, degranulation and generation of reactive oxygen species (ROS). Each of these inflammatory events can be suppressed by circulating alpha-1 antitrypsin (A1AT). A1AT is an acute phase protein increasing during inflammation, however, it may circulate as an inactive polymeric protein. The aim was to analyze how different types of A1AT can affect anti-PR3 mediated neutrophil activation. Granulocytes were obtained from the blood of healthy volunteers and purified by density gradient centrifugation. Effects of A1AT on IgG anti-PR3-mediated neutrophil activation were evaluated by stimulation of the cells with native IgG anti-PR3 antibodies in the presence of native or polymerized A1AT. Analyses of selected proinflammatory genes expression were performed using quantitative real-time. Flow cytometry was used to study the cell membrane PR3, its binding by anti-PR3 IgG, and production of ROS at presence A1AT. Neutrophil elastase complexes with A1AT were measured by ELISA. Native A1AT inhibited formation of the immune complex of PR3 with anti-PR3 and anti-PR3-mediated neutrophil activation/ROS production. Protective effect of polymerized A1AT against these events was diminished at least fivefold. Native A1AT can prevent pivotal events of neutrophils' activation by anti-PR3 IgG, the main autoantibody in anti-PR3 dependent vasculitis. Inhibitory properties of polymerized A1AT, decreased plausibly due to a loss of anti-protease function, can explain more severe course of the disease in subjects with deficiency of A1AT.

Protection of liver sinusoidal endothelial cells from hypoxia-reoxygenation induced apoptosis by alpha-1 antitrypsin in vitro

To investigate the effect of alpha-1 antitrypsin on ischemia-reperfusion injury of human liver sinusoidal endothelial cells (LSECs). LSECs were cultured and put into 4 degrees C refrigerator for 12 hours and then into 37 degrees C culture box with 95% O(2) and 5% CO(2) for 2 - 6 hours to establish an experimental hypoxia-reoxygenation injury model. The LSECs were inoculated in 24-pit culture plate and L-NAME, NO inhibitor, SNAP, a NO supplier, BB3103, a matrix metalloproteinase (MMP) inhibitor, or alpha-1 antitrypsin of different concentrations were added. The LSECs were put into 4 degrees C refrigerator for 12 hours and then into 37 degrees C culture box with 5% CO(2) for 2 - 6 hours. The supernatant was collected to detect the production of nitric oxide (NO) and activity of MMPs. LSECs were cultured under conditions of presence or absence of alpha-1 antitrypsin and normal temperature and oxygen concentration, low-temperature and hypoxia, and low temperature and hypoxia -reoxygenation respectively. Then the supernatant was collected to detect the activities of MMP-2 and MMP-9 with zymography and the production of NO with determination of nitrite concentration and expression of eNOS and iNOS by immunohistochemistry. Immunohistochemistry showed that LSECs were alpha-1 trypsin positive, RT-PCR showed LSECs did not express alpha-1 trypsin mRNA. TUNEL staining showed that hypothermia for 12 hours caused apoptosis of LSECs, apoptosis of LSECs was more obvious after hypothermia and hypoxia-reoxygenation; however, with the presence of alpha-1 trypsin apoptosis of LSECs was significantly decreased after hypothermia and hypoxia-reoxygenation. Hypoxia-reoxygenation induced apoptosis was significantly decreased by L-NAME and BB3103 and increased by SNAP. significantly decreased the apoptosis Zymography showed a significant increase of MMP production, in the forms of proMMP-2 and proMMP-9, in LSECs, paralleling with the number of apoptotic LSECs; and alpha-1 trypsin significantly inhibited the MMP activity during hypothermia and hypoxia-reoxygenation dose-dependently. Paralleling with the number of apoptotic LSECs, the expression of iNOS and eNOS, especially the former, was significantly increased after hypothermia and hypoxia-reoxygenation. L-NAME significantly decreased and SNAP significantly increased the production of NO during hypothermia and hypoxia-reoxygenation. The NOS expression and NO production of LSECs during hypothermia and hypoxia-reoxygenation were inhibit by alpha-1 trypsin dose-dependently. alpha-1 antitrypsin protects LSEC from apoptosis during hypothermia and hypoxia-reoxygenation injury by decreasing NO production and inhibiting MMP activity.