Assessment of Alpha-1 Antitrypsin Deficiency in Patients with Severe Chronic Obstructive Pulmonary Disease

Background and Aims: Chronic obstructive pulmonary disease (COPD) is a kind of pulmonary diseases characterized by chronic obstruction of lung that is in the form of a diffuse narrowing of airways resulting in air flow resistance. Alpha-1 antitrypsin (AAT) deficiency is genetically relatively common risk factor in patients with COPD throughout the world and the exact cause of its prevalence is unknown. We therefore performed a study to determine the frequency of AAT deficiency in patients with severe COPD compared to the healthy controls. Materials and Methods: In this cross-sectional case control study, AAT serum level in 60 patients with severe COPD for whom the history and spirometry test with FEV1 < 50% had been confirmed based on gold criteria as well as 60 healthy controls, were tested using commercial kit and nephelometry method. Results: The lowest serum levels of AAT measured in patients was < 0.349 g/l and the highest was 3.099 g/l. These were obtained in healthy subjects as 1.180 g/l and 4.195 g/l respectively. Out of 60 patients, 4 (6.7%) had partial deficiency of AAT (AAT < 1 g/l) and 6 (10%) had definite shortage of AAT (AAT < 0.5 g/l). In healthy subjects, we did not find any definite and relative lack of AAT. The comparison of results obtained from these two groups indicated a significant difference between frequency of AAT (P=0.001). Conclusions: Our findings revealed the frequency of AAT deficiency, as a factor involved in COPD disease, to be 10% and can be the reason for the high prevalence and severity of COPD in Zahedan city.